Individual provider Active NPI

Ban Hong Lim, PH.D.

  • Psychologist
  • Los Angeles, CA
National Provider Identifier
1518415975
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY29590 Issued in CA
Practice address
221 Westwood Plaza
Box 951556
Los Angeles, CA 90095
Phone
(310) 825-0768
Fax
(310) 206-7365
NPI assigned
Sep 14, 2016
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Psychologist 103T00000X PSY29590 CA Primary

Addresses

Primary practice location

221 Westwood Plaza
Box 951556
Los Angeles, CA 90095

Mailing address

13131 Park Place Unit 104
Hawthorne, CA 90250
Phone (785) 312-4077

Other practice location 1

12837 Flushing Meadows Dr
Suite 220
Saint Louis, MO 63131-1824
Phone (314) 516-7458

Other names 1

  • Dr. Phylice Lim Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 3, 2025 through Mar 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY29590CAMDPsychologist
29590CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1518415975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13131 PARK PLACE UNIT 104",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "90250",
            "telephone_number": "785-312-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 WESTWOOD PLAZA",
            "address_2": "BOX 951556",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90095",
            "telephone_number": "310-825-0768",
            "fax_number": "310-206-7365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12837 Flushing Meadows Dr",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631311824",
            "country_code": "US",
            "telephone_number": "314-516-7458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIM",
        "first_name": "BAN HONG",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY29590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHYLICE",
            "last_name": "LIM",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.