Healthcare Provider Details

I. General information

NPI: 1336050939
Provider Name (Legal Business Name): EUJENE CHUNG PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 GREENSBORO DR STE 550
MC LEAN VA
22102-5146
US

IV. Provider business mailing address

1033 W BROAD ST APT 343
FALLS CHURCH VA
22046-4688
US

V. Phone/Fax

Practice location:
  • Phone: 703-988-6861
  • Fax:
Mailing address:
  • Phone: 503-799-1703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: