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General NPI Number Information
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NPI Number | 1700066032
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Entity Type | Individual
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Provider Name | MONICA SERRAO KIM LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/03/2007
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 641 HIGUERA ST SUITE 202
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-3549
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Country | US
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Telephone | 805-242-8434
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Fax | 805-242-4571
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Provider Business Mailing Address
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Address Line | PO BOX 1934
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93406-1934
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Country | US
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Telephone | 805-242-8434
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Fax | 805-242-4571
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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 | MFC 53847
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License Number State | CA
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