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Diana Young-Hee Kim

Marriage & Family Therapist

Behavioral Health & Social Service Providers

5122 Katella Ave Ste 305, Los Alamitos, CA 90720-2831

PECOS Enrollment

This provider is enrolled in PECOS as DIANA KIM.

Based on the most recent information from CMS, provider Diana Young-Hee Kim is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1962933895
Provider Type
Individual
Full Name
Kim, Diana Young-Hee
Gender
Female

Sole Proprietor
No
Enumeration Date
3/22/2017
Last Updated
7/15/2021

Contact Information

Practice Location

5122 Katella Ave Ste 305, Los Alamitos, CA 90720-2831

(562) 596-2142

Unlisted Fax

Mailing Location

5122 Katella Ave Ste 305, Los Alamitos, CA 90720-2831

(562) 596-2142

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License LMFT118380 California

Diana Young-Hee Kim

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Hentges, Rhisie

Dedeaux, Roya

Schrock, Rebecca

Pearman, Heather Elizabeth

Youngsma Grant, Lishelle Dawn

Hill, Ryan

Nelson-Chung, Michele

Nguyen, Bao-Chau Thi

Shifflett-Collins, Karen Kay

Buechler, Victor