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General NPI Number Information
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NPI Number | 1629856281
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Entity Type | Individual
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Provider Name | KRISTI JUNG
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Gender | Female
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 82 TABLE MOUNTAIN BLVD
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City | OROVILLE
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State | CA
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Zip | 95965-3578
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Country | US
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Telephone | 925-628-1056
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Fax |
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Provider Business Mailing Address
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Address Line | 553 BIG BASIN DR
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City | BRENTWOOD
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State | CA
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Zip | 94513-5526
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Country | US
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Telephone | 925-628-1056
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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