Lili Yu Lim Kim Reboul, PSY. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 21450 Issued in CA

Practice address

150 Paularino Ave Ste C-100
Costa Mesa, CA 92626-3301

Phone

(323) 528-7644

NPI assigned

Sep 25, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Lili Yu Lim Kim Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253836800000",
    "number": "1346574159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PAULARINO AVE STE C-100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263301",
            "telephone_number": "323-528-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PAULARINO AVE STE C-100",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263301",
            "telephone_number": "323-528-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBOUL",
        "first_name": "LILI",
        "middle_name": "YU LIM KIM",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-25",
        "last_updated": "2009-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 21450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILI",
            "last_name": "KIM",
            "middle_name": "YU LIM",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Psychologist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; 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.