Kaetlyn Alysse Eun Hae Kim, is a
Student In An Organized Health Care Education/training Program based in La Verne, California. Kaetlyn Alysse Eun Hae Kim is licensed to practice in NU (license number ) and her current practice location is
1350 3rd St, La Verne, California. She can be reached at her office (for appointments etc.) via phone at
(909) 593-2581.
NPI number for Kaetlyn Alysse Eun Hae Kim is 1376269225 and her current mailing address is 1350 3rd St, La Verne, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1376269225.
Healthcare Provider's Profile
| Full Name | Kaetlyn Alysse Eun Hae Kim |
|---|
| Gender | Female |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 1350 3rd St, La Verne, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1376269225
- Provider Enumeration Date: 10/12/2022
- Last Update Date: 10/09/2024
Medical Identifiers
Medical identifiers for Kaetlyn Alysse Eun Hae Kim such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1376269225 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (NU) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kaetlyn Alysse Eun Hae Kim is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kaetlyn Alysse Eun Hae Kim,
1350 3rd St,
La Verne, CA 91750-5201
Ph: (909) 593-2581 | Kaetlyn Alysse Eun Hae Kim,
1350 3rd St,
La Verne, CA 91750-5201
Ph: (909) 593-2581 |
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