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General NPI Number Information
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NPI Number | 1902040561
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Entity Type | Individual
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Provider Name | JANE JUNE UN
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Gender | Female
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 1666 N. MAIN ST SUITE 400 WESTERN YOUTH SERVICES/BOYS AND GIRLS CLUB
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City | SANTA ANA
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State | CA
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Zip | 92701-4599
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Country | US
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Telephone | 714-532-7951
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Fax |
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Provider Business Mailing Address
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Address Line | 455 S WESTRIDGE CIR
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City | ANAHEIM
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State | CA
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Zip | 92807-3733
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Country | US
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Telephone | 714-606-8862
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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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