Jessica Mifa Kim, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

118456 Issued in CA

Practice address

4707 Gambier St
Los Angeles, CA 90032-2017

Phone

(310) 800-0881

NPI assigned

Oct 28, 2016

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

Other names 1

• Jessica Kim Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1982156626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 GAMBIER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900322017",
            "telephone_number": "310-800-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 GAMBIER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900322017",
            "telephone_number": "310-800-0881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15305 Rayen St",
            "address_purpose": "LOCATION",
            "city": "North Hills",
            "state": "CA",
            "postal_code": "913435117",
            "country_code": "US",
            "telephone_number": "818-892-3423",
            "fax_number": "818-893-4509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JESSICA",
        "middle_name": "MIFA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-28",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "118456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KIM",
            "credential": "LMFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jeong Min Kim
• Jeong Su Kim, OD
• Jeong Un Kim, PH. D.
• Jessica Kim
• Jessica Kim
• Jessie Kim
• Ji Ae Janice Kim, FNP-BC
• Ji Ah Kim, CRNA
• Ji Eun Kim, PA-C
• Ji Hye Kim

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.