Active NPI
Sotha Chhim
- Marriage & Family Therapist
- Long Beach, CA
National Provider Identifier
1336347111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 105193
- Practice address
- 2390 Pacific Ave
Long Beach, CA 90806 - Phone
- (562) 988-1863
- NPI assigned
- Jul 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | |||
| Marriage & Family Therapist | 106H00000X | 105193 | CA | Primary |
Addresses
Primary practice location
2390 Pacific Ave
Long Beach, CA 90806
Mailing address
2390 Pacific Ave
Long Beach, CA 90806-3051
Phone (562) 988-1863
Other practice location 1
605 W Olympic Blvd Ste 600
Los Angeles, CA 90015-1475
Phone (213) 553-1884
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105193 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Special Service for Groups | Past | Accepting new patients | |
| Cambodian Association of America | 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
- Long Beach, CA
- NPI 1891035242
-
- Case Management Agency
- Long Beach, CA
- NPI 1912029273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533168000000",
"number": "1336347111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2390 PACIFIC AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908063051",
"telephone_number": "562-988-1863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2390 PACIFIC AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90806",
"telephone_number": "562-988-1863"
}
],
"practiceLocations": [
{
"address_1": "605 W Olympic Blvd Ste 600",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900151475",
"country_code": "US",
"telephone_number": "213-553-1884",
"fax_number": "213-236-9662",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHHIM",
"first_name": "SOTHA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-03",
"last_updated": "2018-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "105193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.