Individual provider Active NPI

Han NA Kim

  • Mental Health Counselor
  • Mission Hills, CA
National Provider Identifier
1417830589
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
10200 Sepulveda Blvd Ste 100
Mission Hills, CA 91345-3316
Phone
(323) 879-9176
NPI assigned
Jul 28, 2025
Last updated
Jul 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

10200 Sepulveda Blvd Ste 100
Mission Hills, CA 91345-3316

Mailing address

15537 Nordhoff St Apt 8
North Hills, CA 91343-3272
Phone (310) 971-3571

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Integrated Care Marriage and Family Therapy Inc. Mental Health CurrentSince Nov 24, 2025 Accepting new patients

Locations

10200 Sepulveda Blvd
Ste 100
Mission Hills, CA 91345
Phone (323) 879-9176

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1417830589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15537 NORDHOFF ST APT 8",
            "city": "NORTH HILLS",
            "state": "CA",
            "postal_code": "913433272",
            "telephone_number": "310-971-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 SEPULVEDA BLVD STE 100",
            "city": "MISSION HILLS",
            "state": "CA",
            "postal_code": "913453316",
            "telephone_number": "323-879-9176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HAN NA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.