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General NPI Number Information
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NPI Number | 1255829479
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Entity Type | Individual
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Provider Name | HYEYOUNG JUNG LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/24/2018
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 3333 S BREA CANYON RD STE 107
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City | DIAMOND BAR
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State | CA
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Zip | 91765-3782
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Country | US
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Telephone | 323-823-8563
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Fax |
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Provider Business Mailing Address
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Address Line | 2271 W MALVERN AVE # 319
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City | FULLERTON
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State | CA
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Zip | 92833-2106
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Country | US
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Telephone | 323-823-8563
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW79621
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License Number State | CA
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