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: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 VAN NUYS BLVD STE 201
SHERMAN OAKS CA
91403-1700
US

IV. Provider business mailing address

4940 VAN NUYS BLVD STE 201
SHERMAN OAKS CA
91403-1700
US

V. Phone/Fax

Practice location:
  • Phone: 818-985-0560
  • Fax: 818-985-7193
Mailing address:
  • Phone: 818-985-0560
  • Fax: 818-985-7193

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: