Healthcare Provider Details

I. General information

NPI: 1598670770
Provider Name (Legal Business Name): GINNA BYUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 OLD COUNTY RD UNIT 1031
BELMONT CA
94002-3985
US

IV. Provider business mailing address

1325 OLD COUNTY RD UNIT 1031
BELMONT CA
94002-3985
US

V. Phone/Fax

Practice location:
  • Phone: 949-607-9866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: