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General NPI Number Information
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NPI Number | 1356800452
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Entity Type | Organization
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Legal Business Name | LICENSED CLINICAL SOCIAL WORKER YISOOK BAIK COUNSELING INC.
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 7825 ENGINEER RD STE 203E
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City | SAN DIEGO
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State | CA
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Zip | 92111-1926
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Country | US
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Telephone | 619-933-3486
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Fax |
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Provider Business Mailing Address
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Address Line | 17905 AGUAMIEL RD
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City | SAN DIEGO
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State | CA
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Zip | 92127-1039
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Country | US
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Telephone | 858-217-6926
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. YISOOK BAIK
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Credential | LCSW
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Telephone | 201-835-2237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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