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General NPI Number Information
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NPI Number | 1447467212
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Entity Type | Individual
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Provider Name | JAYMA E KIM M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12630 MONTE VISTA RD SUITE 202
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City | POWAY
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State | CA
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Zip | 92064-2530
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Country | US
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Telephone | 858-675-2223
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Fax | 858-485-0574
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Provider Business Mailing Address
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Address Line | 12630 MONTE VISTA RD SUITE 202
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City | POWAY
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State | CA
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Zip | 92064-2530
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Country | US
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Telephone | 858-675-2223
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Fax | 858-485-0574
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC36096
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License Number State | CA
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