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General NPI Number Information
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NPI Number | 1336489384
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Entity Type | Individual
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Provider Name | HYANGSOOK JUNG PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 5TH ST. AND WESTERN AVE.
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City | NORCO
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State | CA
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Zip | 92860
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Country | US
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Telephone | 951-737-2683
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Fax | 951-273-2974
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Provider Business Mailing Address
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Address Line | P.O. BOX 1841
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City | NORCO
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State | CA
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Zip | 92860
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Country | US
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Telephone | 951-737-2683
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Fax | 951-273-2974
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 21782
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License Number State | CA
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