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General NPI Number Information
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NPI Number | 1285422212
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Entity Type | Organization
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Legal Business Name | KEN KANG MARRIAGE AND FAMILY THERAPY INC.
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 2615 PACIFIC COAST HWY STE 322
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-2227
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Country | US
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Telephone | 323-577-8604
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Fax |
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Provider Business Mailing Address
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Address Line | 2216 MARSHALLFIELD LN # B
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City | REDONDO BEACH
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State | CA
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Zip | 90278-5016
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Country | US
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Telephone | 917-686-0428
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. KENNETH SUK KANG
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Credential | LMFT
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Telephone | 323-577-8604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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