Jane Kim, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

75259 Issued in CA

Practice address

23248 Colony Park Dr
Carson, CA 90745-5574

Phone

(310) 422-5979

Fax

(000) 000-0000

NPI assigned

Oct 7, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1376878462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23248 COLONY PARK DR",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907455574",
            "telephone_number": "310-422-5979",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23248 COLONY PARK DR",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907455574",
            "telephone_number": "310-422-5979",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW34424",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW34424",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "75259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daejunnah Renee Kendrick
• Savannah Keyse, LCSW, MSW
• Omid Khonsari, PHARM.D.
• Joye Kiernan, MS, RD
• Hyungchul Kim
• Kim King, NP
• Justin Len Kirkendall
• Jennifer Gage Knapp
• Jacqueline L Kogan, NBC-HWC
• Namie Kong, DMD

• Clinical Social Worker in Carson, CA
• Providers in Carson, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.