MEDICARE: JUNG PSYCHOLOGICAL CORPORATION

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	103TC0700X	Clinical Psychologist
2	103T00000X	Psychologist

General Provider Information

NPI Number	:	1861340705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUNG PSYCHOLOGICAL CORPORATION

Provider Business Mailing Address
First Line	:	454 S MARENGO AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-3129
Country	:	US
Telephone Number	:	747-221-6354
Fax Number	:

Provider Business Practice Location Address
First Line	:	454 S MARENGO AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91101-3129
Country	:	US
Telephone Number	:	747-221-6354
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. BRENNAN JUNG
Credential	:	PSYD
Telephone Number	:	747-221-6354

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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