Active NPI
Mia Y Kim, M.S.
- Marriage & Family Therapist
- Covina, CA
National Provider Identifier
1003945783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMFT 50477
- Practice address
- 560 S San Jose Ave
Covina, CA 91723-3144 - Phone
- (626) 967-5103
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMFT 50477 | CA | Primary |
Addresses
Primary practice location
560 S San Jose Ave
Covina, CA 91723-3144
Mailing address
1738 Federal Ave Apt 1
Los Angeles, CA 90025-4182
Phone (310) 477-1590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMFT 50477 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Integrated Family and Health Services | Past | Accepting new patients | |
| Center for Integrated Family and Health Services | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Covina, CA
- NPI 1326209982
-
- Community/Behavioral Health Agency
- Baldwin Park, CA
- NPI 1780928655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003945783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1738 FEDERAL AVE APT 1",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900254182",
"telephone_number": "310-477-1590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 S SAN JOSE AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917233144",
"telephone_number": "626-967-5103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MIA",
"middle_name": "Y",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMFT 50477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.