Simon Kim, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY22548 Issued in CA

Practice address

9600 Veterans Drive a 116 DM
VA Puget Sound Health Care System
Tacoma, WA 98493-2539

Phone

(253) 583-1682

NPI assigned

Jan 29, 2008

Last updated

Feb 2, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1538346820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 VETERANS DRIVE SW A 116 DM BLDG 4",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984930001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 VETERANS DRIVE A 116 DM",
            "address_2": "VA PUGET SOUND HEALTH CARE SYSTEM",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984932539",
            "telephone_number": "253-583-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-29",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22548",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60443812",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Y Kim, DO
• S Kim
• Sam Kim
• Sarah G Kim
• Shin Kim, O.D.
• Sue Jin Kim, PHARMD
• Sung Kim, PA-C
• Sylvia Kim
• Tiffany Janel Thiel Kim, MD
• Timothy Kim, DO

• Clinical Psychologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.