Healthcare Provider Details

I. General information

NPI: 1962086322
Provider Name (Legal Business Name): SARAH SUNGMIN JANG AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 GREAT OAKS BLVD STE 108
SAN JOSE CA
95119-1314
US

IV. Provider business mailing address

90 GREAT OAKS BLVD STE 108
SAN JOSE CA
95119-1314
US

V. Phone/Fax

Practice location:
  • Phone: 408-281-0708
  • Fax:
Mailing address:
  • Phone: 408-281-0708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC21373
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT160122
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: