SOO JIN KIM (NPI# 1649736265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649736265 |
| Entity Type | Individual |
| Full Name | SOO JIN KIM |
| Other Name | AMY JIN KIM |
| Credential | MS |
| Practice Address |
12443 Lewis St Ste 201 Garden Grove CA 92840-4650 |
| Practice Telephone | 7147484440 |
| Mailing Telephone | 7147484440 |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-02-19 |
| 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 |
|---|---|---|---|---|
| 1811368376 | Soo Kim | Pharmacist | 757 Galaxy Heights Dr, La Canada Flintridge, CA 91011-1832 | 2015-10-09 |
| 1639511546 | Soo Kim | Dietitian, Registered | 1013 Ledgemont Dr, Plano, TX 75025-3510 | 2013-07-19 |
| 1932318219 | Soo H Kim | Optometrist | 25574 Dapper Ct, Chantilly, VA 20152-6318 | 2007-05-22 |
| 1619093739 | Soo Youn Kim | Optometrist | 14147 Pipeline Ave, Chino, CA 91710-5618 | 2007-03-21 |
| 1912064429 | Soo Yew Kim | Dentist | 1717 S Hoover St, Los Angeles, CA 90006-4958 | 2007-01-03 |
| 1851475958 | Soo R. Kim | Internal Medicine | 29 W Oneida St, Oswego, NY 13126 | 2006-10-25 |
| 1376578260 | Soo Bin Kim | Dentist | 14855 Blanco Rd Ste 413, San Antonio, TX 78216-7731 | 2006-07-11 |
| 1053870618 | Soo Kim | Technician | 8290 W Sahara Ave Ste 260, Las Vegas, NV 89117-8933 | 2019-03-13 |
| 1396271185 | Soo M Kim | Student in an Organized Health Care Education/Training Program | 1210 Sw 136th St, Burien, WA 98166-1214 | 2017-05-11 |
| 1073960530 | Soo K Kim | Acupuncturist | 385 Sylvan Ave, Suite 10, Englewood Cliffs, NJ 07632-2726 | 2016-05-15 |
| Street Address |
12443 LEWIS ST STE 201 |
| City | GARDEN GROVE |
| State | CA |
| Zip Code | 92840-4650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760748719 | Rachel L Rodriguez | Behavioral Analyst | 12443 Lewis St Ste 201, Garden Grove, CA 92840-4650 | 2012-04-04 |
| 1144854514 | Hea Yoon Jung | Behavior Technician | 12443 Lewis St Ste 201, Garden Grove, CA 92840-4650 | 2020-02-25 |
| 1871127241 | Deanna Lynn Blake | Behavior Technician | 12443 Lewis St Ste 201, Garden Grove, CA 92840-4650 | 2020-02-25 |
| 1407480874 | Justin Parra | Behavior Technician | 12443 Lewis St Ste 201, Garden Grove, CA 92840-4650 | 2020-02-25 |
| 1679103683 | Bianca Sheree Diaz | Behavior Technician | 12443 Lewis St Ste 201, Garden Grove, CA 92840-4650 | 2020-01-17 |
| 1487284410 | Jorge Preciado | Behavior Technician | 12443 Lewis St Ste 201, Garden Grove, CA 92840-4650 | 2020-01-17 |
| 1790323038 | Ashley Barber | Behavior Technician | 12443 Lewis St Ste 201, Garden Grove, CA 92840-4650 | 2019-12-17 |
| 1215573266 | Katahdin Rendino | Behavior Technician | 12443 Lewis St Ste 201, Garden Grove, CA 92840-4650 | 2019-11-25 |
| 1295370617 | Riley Koepsell | Behavior Technician | 12443 Lewis St Ste 201, Garden Grove, CA 92840-4650 | 2019-11-08 |
| 1245875822 | Rosa Maria Merhoff | Behavior Technician | 12443 Lewis St Ste 201, Garden Grove, CA 92840-4650 | 2019-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588283808 | Kimberly Gaeta | Behavioral Analyst | 123935 Lewis Street, Ste 202, Garden Grove, CA 92840 | 2020-04-16 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1376005934 | Sekboppa Sor | Nurse Practitioner | An Lanh Free Clinic, 10861 Acacia Pkwy., Garden Grove, CA 92840 | 2019-04-03 |
| 1346730116 | Vinh Le Tran | Pharmacist | 12666 Brookhurst St. Suite 110, Garden Grove, CA 92840 | 2018-05-16 |
| 1841715232 | Scott R. Blair | Physician Assistant | 12828 Harbor Blvd Ste 200, Garden Grove, CA 92840 | 2017-08-07 |
| 1881049492 | Carmen Keally | Dietitian, Registered | 12602 9th St, Garden Grove, CA 92840 | 2016-05-02 |
| 1548688732 | House Call Medical Associates, Inc. | Internal Medicine | 12865 Main St Ste 105, Garden Grove, CA 92840 | 2014-04-03 |
| 1851733059 | Carly Ann Wade | Marriage & Family Therapist | 12755 Brookhurst St. Ste 116, Garden Grove, CA 92840 | 2013-07-29 |
| 1003159864 | Priyal Shah Ohri | Dentist | 10602 Chapman Ave, Suite 200, Garden Grove, CA 92840 | 2013-03-30 |
| 1770853244 | Joseph Pham | Pharmacist | 12001 Euclid St., Garden Grove, CA 92840 | 2011-12-30 |
| Find all providers in zip 92840 | ||||
| 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 |
|---|---|---|---|---|
| 1538787395 | Rajan Singh | Behavior Technician | 5462 Park Ave, Garden Grove, CA 92845-2450 | 2020-07-08 |
| 1740801075 | Evelyn Aponte | Behavior Technician | 12570 Brookhurst St Ste 2, Garden Grove, CA 92840-4882 | 2020-04-28 |
| 1841811247 | Alexus Marie Mayares | Behavior Technician | 11191 Gilbert St, Garden Grove, CA 92841-1239 | 2020-04-27 |
| 1922638451 | Andrea Evangelina Montilla | Behavior Technician | 12302 Browning Rd, Garden Grove, CA 92840-2951 | 2020-01-23 |
| 1083255624 | Lauren Firme | Behavior Technician | 12842 Valley View St Ste 207, Garden Grove, CA 92845-2517 | 2019-10-04 |
| 1548801509 | Adrianna Rayn Szlachciuk | Behavior Technician | 13132 Westlake St, Garden Grove, CA 92843-2412 | 2019-10-01 |
| 1730737123 | Uyen Ngoc Kha | Behavior Technician | 12622 Agnes Stanley St, Garden Grove, CA 92841-4603 | 2019-08-28 |
| 1457908170 | Jaelyn Le | Behavior Technician | 13151 Rainbow St, Garden Grove, CA 92843-1829 | 2019-08-19 |
| 1396397170 | Rosa Cortez | Behavior Technician | 12443 Lewis Street, #201, Garden Grove, CA 92840 | 2019-07-12 |
| 1477112753 | Dawn Lee Smith | Behavior Technician | 12062 Valley View St Ste 103, Garden Grove, CA 92845-1738 | 2019-06-10 |
| Find all providers in GARDEN GROVE | ||||
| City | GARDEN GROVE |
| Zip Code | 92840 |
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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.