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NPI Code Detail

MEDICARE: ALICE JI YOON JUNG

MEDICARE: ALICE JI YOON JUNG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner
2106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1033575949
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE JI YOON JUNG
Provider Business Mailing Address
First Line : 6055 E WASHINGTON BLVD STE 900
Second Line :
City : COMMERCE
State : CA
Zip : 90040-2453
Country : US
Telephone Number : 323-301-8481
Fax Number :
Provider Business Practice Location Address
First Line : 170 S OAKLAND AVE
Second Line :
City : PASADENA
State : CA
Zip : 91101-2561
Country : US
Telephone Number : 818-244-8403
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2016
Last Update Date : 04/27/2022

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Directions to “ ALICE JI YOON JUNG ” Practice Location

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