Elisa Kim, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

11624377 Issued in CA

Practice address

75 E Santa Clara St
San Jose, CA 95113-1827

Phone

(866) 227-1211

NPI assigned

Mar 27, 2018

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

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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1467957910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 AMADOR VILLAGE CT APT 21",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945441275",
            "telephone_number": "925-354-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E SANTA CLARA ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951131827",
            "telephone_number": "866-227-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ELISA",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11624377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connie Kim, O.D.
• Dae Ha Kim, DDS
• Dai Jung Kim, M.D.
• Dan Kim
• Daniel Jiyong Kim, D.C.
• Emily Kim
• Esther Ohn Kim, O.D.
• Eun Ah Kim, MA, MFT
• Eun Hyuk Kim, MD
• Grace Jee-Young Kim, ASW, PPSC

• Behavior Analyst in San Jose, CA
• Providers in San Jose, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.

Verify at the official NPI Registry.