Active NPI
Susanna S Kim, M.A.
- Speech-Language Pathologist
- Harbor City, CA
National Provider Identifier
1447456892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4435
- Practice address
- 25825 Vermont Ave
Harbor City, CA 90710-3518 - Phone
- (310) 517-3945
- NPI assigned
- Jun 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4435 | CA | Primary |
Addresses
Primary practice location
25825 Vermont Ave
Harbor City, CA 90710-3518
Mailing address
102 Argonne Ave
#7
Long Beach, CA 90803-3284
Phone (217) 721-1146
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4435 | CA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447456892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 ARGONNE AVE",
"address_2": "#7",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908033284",
"telephone_number": "217-721-1146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25825 VERMONT AVE",
"city": "HARBOR CITY",
"state": "CA",
"postal_code": "907103518",
"telephone_number": "310-517-3945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SUSANNA",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "4435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harbor City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.