MEDICARE: LISA BROOKE CHUNG LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	163666	CA

General Provider Information

NPI Number	:	1346172624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA BROOKE CHUNG LMFT

Provider Business Mailing Address
First Line	:	5632 VAN NUYS BLVD # 1388
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91401-4602
Country	:	US
Telephone Number	:	714-791-2675
Fax Number	:

Provider Business Practice Location Address
First Line	:	5455 SYLMAR AVE APT 1303
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91401-5149
Country	:	US
Telephone Number	:	714-791-2675
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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