Healthcare Provider Details

I. General information

NPI: 1306502422
Provider Name (Legal Business Name): PAUL JASPR CHANG LMFT, APCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2021
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 S ANAHEIM BLVD STE 101
ANAHEIM CA
92805-6258
US

IV. Provider business mailing address

1360 S ANAHEIM BLVD STE 101
ANAHEIM CA
92805-6258
US

V. Phone/Fax

Practice location:
  • Phone: 714-475-4502
  • Fax:
Mailing address:
  • Phone: 714-948-7641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT144415
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC19024
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: