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NPI Code Detail

MEDICARE: SUNNYO PAK M.F.T.

MEDICARE: SUNNYO PAK M.F.T.
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
1106H00000XMarriage & Family Therapist
2101YA0400XAddiction (Substance Use Disorder) Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548479132
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUNNYO PAK M.F.T.
Provider Business Mailing Address
First Line : 3288 EL CAJON BLVD STE 13
Second Line :
City : SAN DIEGO
State : CA
Zip : 92104-1430
Country : US
Telephone Number : 619-521-5720
Fax Number : 619-521-5728
Provider Business Practice Location Address
First Line : 3288 EL CAJON BLVD STE 13
Second Line :
City : SAN DIEGO
State : CA
Zip : 92104-1430
Country : US
Telephone Number : 619-521-5720
Fax Number : 619-521-5728
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 09/11/2025

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Directions to “ SUNNYO PAK M.F.T.” Practice Location

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