| Counseling & Spiritual Care Center | |
|
7342 Orangethorpe Ave Ste A107 Buena Park CA 90621-3328 | |
| (562) 445-4735 | |
| (714) 509-1140 |
| Full Name | Counseling & Spiritual Care Center |
|---|---|
| Speciality | Psychologist |
| Location | 7342 Orangethorpe Ave Ste A107, Buena Park, California |
| Authorized Official Name and Position | Christine I Kim (CEO) |
| Authorized Official Contact | 5624454735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling & Spiritual Care Center 14035 Santa Barbara St La Mirada CA 90638-6596 Ph: (562) 445-4735 | Counseling & Spiritual Care Center 7342 Orangethorpe Ave Ste A107 Buena Park CA 90621-3328 Ph: (562) 445-4735 |
| NPI Number | 1902456031 |
|---|---|
| Provider Enumeration Date | 09/20/2019 |
| Last Update Date | 11/02/2021 |
| Certification Date | 11/02/2021 |
| Medicare PECOS PAC ID | 2264865815 |
|---|---|
| Medicare Enrollment ID | O20191212000637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902456031 | NPI | - | NPPES |
| PSY25323 | Other | CA | PSYCHOLOGY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Christine Euneso Kim |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194895078 PECOS PAC ID: 6305119892 Enrollment ID: I20170905002909 |
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