Individual provider Active NPI

Sarah Kim, MA

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1154916203
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
149508 Issued in CA
Practice address
3680 Wilshire Blvd Ste P04-1400
Los Angeles, CA 90010-2707
Phone
(440) 678-8335
NPI assigned
Mar 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT121764 CA
Marriage & Family Therapist 106H00000X 149508 CA Primary

Addresses

Primary practice location

3680 Wilshire Blvd Ste P04-1400
Los Angeles, CA 90010-2707

Mailing address

3680 Wilshire Blvd Ste P04-1400
Los Angeles, CA 90010-2707
Phone (440) 678-8335

Other names 1

  • Daeun Kim Former name

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 Arts

State licenses

LicenseStateTypeSpecialty
AMFT121764CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1154916203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 WILSHIRE BLVD STE P04-1400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102707",
            "telephone_number": "440-678-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 WILSHIRE BLVD STE P04-1400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900102707",
            "telephone_number": "440-678-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SARAH",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT121764",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "149508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAEUN",
            "last_name": "KIM",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.