Healthcare Provider Details

I. General information

NPI: 1093624439
Provider Name (Legal Business Name): JIHYUN KANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10200 SEPULVEDA BLVD STE 100
MISSION HILLS CA
91345-3316
US

IV. Provider business mailing address

10200 SEPULVEDA BLVD STE 100
MISSION HILLS CA
91345-3316
US

V. Phone/Fax

Practice location:
  • Phone: 323-879-9176
  • Fax: 818-484-4084
Mailing address:
  • Phone: 323-879-9176
  • Fax: 818-484-4084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number23398
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: