Healthcare Provider Details

I. General information

NPI: 1821855958
Provider Name (Legal Business Name): JAYNA JUNG MFT-TRAINEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11050 ARTESIA BLVD STE E
CERRITOS CA
90703-2542
US

IV. Provider business mailing address

3740 HOWARD AVE
LOS ALAMITOS CA
90720-3618
US

V. Phone/Fax

Practice location:
  • Phone: 562-860-8838
  • Fax: 562-860-0248
Mailing address:
  • Phone: 562-370-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: