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Deactivated NPI 1639729569 Deactivated / Inactive NPI Male Practitioner

Min Seop Kim , MS

Behavior Analyst • Gardena, CA

⚠️

Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Min Seop Kim has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 12, 2019
NPI Deactivation Date July 16, 2020
Total Practice Duration ~1 Years of Practice (2019 – 2020)

Professional Overview & Biography Verified Profile Summary

Min Seop Kim, MS was a registered Behavior Analyst practicing in Gardena, CA. Throughout an active medical career spanning 1 years, Min Seop Kim provided care at the practice location at 1411 W 190TH ST until profile deactivation on 2020-07-16.

Practice Location & Contact Primary Location

Practice Address

1411 W 190th St

Gardena, CA 902484324

Telephone 3107193908

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Gardena, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 8.8 Yrs
Regional Practice Density
269 Specialists

Practicing in Gardena, CA (20508 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-04-09
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License CA 1-23-69112

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Secondary Practice Locations

25930 Rolling Hills Rd Apt 403

Torrance, CA 905057203

Phone: 6263880498

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Nicole Bollinger

Behavior Analyst

NPI 1003525163
Kristyn Barnes

Behavior Technician

NPI 1003694399
Karen Eckland

Behavior Analyst

NPI 1013604750
Camille Kamarauskas

Behavior Technician

NPI 1013720986
Irene Nino De Rivera

Speech-Language Pathologist

NPI 1013740695
Kaiesha Lockhart

Behavior Technician

NPI 1013848415

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

22 Historical Events
📍
Updated Practice Location April 09, 2026

Registered at 1411 W 190TH ST, GARDENA, CA 902484324 (Tel: 3107193908)

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Updated Business Mailing Address April 09, 2026

Registered at 1411 W 190TH ST, GARDENA, CA 902484324 (Tel: 3107193908)

📍
Updated Practice Location March 30, 2025

Registered at 103 N ASHWOOD AVE APT 906, VENTURA, CA 930031847 (Tel: 6263880498)

📍
Updated Business Mailing Address March 30, 2025

Registered at 103 N ASHWOOD AVE APT 906, VENTURA, CA 930031847 (Tel: 6263880498)

📍
Updated Practice Location March 21, 2024

Registered at 914 140TH AVE NE STE 201, BELLEVUE, WA 980053482 (Tel: 8552237123)

📍
Updated Business Mailing Address March 21, 2024

Registered at PO BOX 33568, SAN DIEGO, CA 921633568 (Tel: 8552237123)

📍
Updated Practice Location February 28, 2024

Registered at 1800 BOREN AVE APT 2512, SEATTLE, WA 981013355 (Tel: 6263880498)

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 31, 2023

Behavior Analyst (License #1-23-69112 in CA)

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Updated Practice Location May 11, 2023

Registered at 2023 DACIAN ST, WALNUT, CA 917893414 (Tel: 6263880498)

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Updated Practice Location March 17, 2023

Registered at 1900 N D ST, SAN BERNARDINO, CA 924053912 (Tel: 9097011874)

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Provider Name / Credentials Updated March 17, 2023

Recorded as MIN SEOP KIM, MS

📍
Updated Practice Location February 21, 2023

Registered at 3346 VAN TASSEL WAY, DUARTE, CA 910101647 (Tel: 6263933181)

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Updated Business Mailing Address February 21, 2023

Registered at 2023 DACIAN ST, WALNUT, CA 917893414 (Tel: 6263880498)

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Provider Name / Credentials Updated February 21, 2023

Recorded as MIN SEOP KIM, BA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 21, 2023

Technician, Other

⚠️
NPI Profile Deactivated July 16, 2020

Record deactivated on July 16, 2020

NPI Profile Active September 12, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location September 12, 2019

Registered at 3346 VAN TASSEL WAY, DUARTE, CA 910101647 (Tel: 6263933181)

📍
Updated Business Mailing Address September 12, 2019

Registered at 2023 DACIAN ST, WALNUT, CA 917893414 (Tel: 6263880498)

👤
Provider Name / Credentials Updated September 12, 2019

Recorded as MIN SEOP KIM, BA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 12, 2019

Technician, Other

🟢
Initial NPI Registration & Enumeration September 12, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1639729569
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 12, 2019
Last Update: April 09, 2026
Deactivation Date: July 16, 2020
Sole Proprietor: Yes

Mailing Address

1411 W 190th St

Gardena, CA 902484324

Phone: 3107193908

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.