STACEY R KIM (NPI# 1568936664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568936664 |
| Entity Type | Individual |
| Full Name | STACEY R KIM |
| Practice Address |
1111 W 6th St Ste 111 Los Angeles CA 90017-1823 |
| Mailing Address |
625 Fair Oaks Ave Ste 200 South Pasadena CA 91030-2694 |
| Practice Telephone | 3234041027 |
| Practice Fax Number | 3233408298 |
| Mailing Telephone | 3233415580 |
| Mailing Fax Number | 3233408298 |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2019-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710333067 | Stacey Kim | Behavioral Analyst | 575 Bayview Ave, Millbrae, CA 94030-1107 | 2016-05-05 |
| 1841525565 | Stacey Kim | Social Worker | 600 N Jordan Ave, Indiana University Counseling and Psychological Service, Bloomington, IN 47405-3190 | 2009-10-14 |
| 1114123171 | Stacey Kim | Pathology | 8700 Beverly Blvd, South Tower, Room 8709, Los Angeles, CA 90048 | 2007-06-26 |
| Street Address |
1111 W 6TH ST STE 111 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90017-1823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255498911 | Schwana Bowe | Licensed Vocational Nurse | 1111 W 6th St Ste 111, Los Angeles, CA 90017-1823 | 2007-01-02 |
| 1316569718 | Christina Marie Del Carmen | Physical Therapist | 1111 W 6th St Ste 111, Los Angeles, CA 90017-1823 | 2020-05-08 |
| 1619523958 | Taryn Nicole El Bayar | Physical Therapist | 1111 W 6th St Ste 111, Los Angeles, CA 90017-1823 | 2019-08-13 |
| 1780140848 | Lily Alexandra Bollinger | Physical Therapist | 1111 W 6th St Ste 111, Los Angeles, CA 90017-1823 | 2019-02-13 |
| 1104399534 | Sophia Taylor | Assistant Behavior Analyst | 1111 W 6th St Ste 111, Los Angeles, CA 90017-1823 | 2019-01-08 |
| 1508345711 | Marisol Garcia-macias | Physical Therapist | 1111 W 6th St Ste 111, Los Angeles, CA 90017-1823 | 2018-08-08 |
| 1568940088 | Nicolette Chantal Buenrostro | Speech-Language Pathologist | 1111 W 6th St Ste 111, Los Angeles, CA 90017-1823 | 2018-08-06 |
| 1306342845 | Roxana Larios Ponce | Specialist/Technologist | 1111 W 6th St Ste 111, Los Angeles, CA 90017-1823 | 2018-04-03 |
| 1194231555 | Kimberly Kay Sinclair | Behavioral Analyst | 1111 W 6th St Ste 111, Los Angeles, CA 90017-1823 | 2017-12-21 |
| 1669830154 | Adriana Nuno Del Cid | Specialist/Technologist | 1111 W 6th St Ste 111, Los Angeles, CA 90017-1823 | 2016-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833617 | Guadalupe Vallejo | Licensed Vocational Nurse | 515 Columbia Avenue, #200, 515 Columbia Avenue, Los Angeles, CA 90017 | 2020-08-25 |
| 1376181768 | Nirlok Corporation | Optometrist | 750 West 7th Street, Los Angeles, CA 90017 | 2019-12-16 |
| 1689228223 | Marycarmen Beltran | Student in an Organized Health Care Education/Training Program | 333 S. Beaudry Ave., Los Angeles, CA 90017 | 2019-08-01 |
| 1639661465 | Robin B Horowitz | Counselor | 333 South Beaudry Avenue, Los Angeles, CA 90017 | 2018-06-06 |
| 1710483797 | Rose Jadidian | Pharmacist | 701 S. Flower, Ste. 3150, Los Angeles, CA 90017 | 2018-03-30 |
| 1417469875 | Marykarla Gallegos | Case Manager/Care Coordinator | 1125 W. 6th St., Suite 103, Los Angeles, CA 90017 | 2017-10-25 |
| 1134646516 | Maria Salas | Rehabilitation Practitioner | 333 S Beaudry Ave., Los Angeles, CA 90017 | 2017-08-25 |
| 1932638202 | Butterfli Technologies Inc | Transportation Broker | 865 S Figueroa St Ste 2750, Los Angeles, CA 90017 | 2017-06-08 |
| 1316493125 | Phamily Love Foundation | Community/Behavioral Health | 626 Wilshire Blvd ., Suite 910, Los Angeles, CA 90017 | 2016-08-31 |
| 1215392188 | Jessica R. Garcia-hillard | Specialist/Technologist | 1111 W. 6th St., Suite 111, Los Angeles, CA 90017 | 2015-12-21 |
| Find all providers in zip 90017 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124628904 | Toya Hill | Behavior Technician | 2229 S Gramercy Pl, Los Angeles, CA 90018-1322 | 2020-10-29 |
| 1346847464 | Cristhina A Perez | Behavior Technician | 158 W 50th St, Los Angeles, CA 90037-3265 | 2020-10-01 |
| 1558975300 | Osariemen Raymond Eguavoen | Behavior Technician | 1826 S Bundy Dr Apt 1, Los Angeles, CA 90025-5222 | 2020-08-31 |
| 1437773199 | Sonia Preciado | Behavior Technician | 13101 W Washington Blvd Ste 13101w, Los Angeles, CA 90066-5131 | 2020-05-29 |
| 1770106866 | Wendy Carrillo | Behavior Technician | 1200 S Figueroa St Apt 2306, Los Angeles, CA 90015-4457 | 2020-05-22 |
| 1831712934 | Guillermo Theodoro Vasquez | Behavior Technician | 340 S St Andrews Pl Apt 107, Los Angeles, CA 90020-4332 | 2020-05-22 |
| 1851910038 | Mirna Alguera | Behavior Technician | 2121 James M Wood Blvd Apt 416, Los Angeles, CA 90006-2218 | 2020-04-08 |
| 1568098085 | Adrian Zaldana | Behavior Technician | 1117 W 18th St, Los Angeles, CA 90015-3325 | 2020-03-16 |
| 1629602628 | Monica Sherlyne Barrios | Behavior Technician | 850 N Mariposa Ave Apt 310, Los Angeles, CA 90029-4602 | 2020-02-27 |
| 1881228294 | Ann Bailey | Behavior Technician | 210 E 60th St, Los Angeles, CA 90003-1209 | 2020-02-24 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90017 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.