Healthcare Provider Details

I. General information

NPI: 1861340705
Provider Name (Legal Business Name): JUNG PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 S MARENGO AVE
PASADENA CA
91101-3129
US

IV. Provider business mailing address

454 S MARENGO AVE
PASADENA CA
91101-3129
US

V. Phone/Fax

Practice location:
  • Phone: 747-221-6354
  • Fax:
Mailing address:
  • Phone: 747-221-6354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRENNAN JUNG
Title or Position: CEO
Credential: PSYD
Phone: 747-221-6354