MEDICARE: PAUL JASPR CHANG LMFT, APCC

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
1	101YM0800X	Mental Health Counselor	APCC10310	CA
2	106H00000X	Marriage & Family Therapist	LMFT144415	CA

General Provider Information

NPI Number	:	1306502422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL JASPR CHANG LMFT, APCC

Provider Business Mailing Address
First Line	:	21545 CENTRE POINTE PKWY
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91350-2947
Country	:	US
Telephone Number	:	661-259-9439
Fax Number	:

Provider Business Practice Location Address
First Line	:	7419 TAMPA AVE UNIT A
Second Line	:
City	:	RESEDA
State	:	CA
Zip	:	91335-2498
Country	:	US
Telephone Number	:	818-321-6637
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2021
Last Update Date	:	01/17/2024

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