Healthcare Provider Details

I. General information

NPI: 1689081788
Provider Name (Legal Business Name): KAREN MOE AUNG PSYD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 NEWPORT BLVD STE 110
COSTA MESA CA
92627-7762
US

IV. Provider business mailing address

PO BOX 50001
IRVINE CA
92619-0001
US

V. Phone/Fax

Practice location:
  • Phone: 925-282-1778
  • Fax:
Mailing address:
  • Phone: 909-544-2311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number36544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: