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NPI Code Detail

MEDICARE: ANGELA KIM MFTI

MEDICARE: ANGELA KIM MFTI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist51875CA

General Provider Information

NPI Number : 1578712154
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA KIM MFTI
Provider Business Mailing Address
First Line : 3517 CAMINITO SIERRA UNIT 102
Second Line :
City : CARLSBAD
State : CA
Zip : 92009-8654
Country : US
Telephone Number : 310-922-2755
Fax Number :
Provider Business Practice Location Address
First Line : 3517 CAMINITO SIERRA UNIT 102
Second Line :
City : CARLSBAD
State : CA
Zip : 92009-8654
Country : US
Telephone Number : 310-922-2755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2008
Last Update Date : 09/18/2008

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Directions to “ ANGELA KIM MFTI” Practice Location

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