Individual provider Active NPI

Jae Chong

  • Marriage & Family Therapist
  • Riverside, CA
National Provider Identifier
1073434809
Registry record updated Jul 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
4996 La Sierra Ave
Riverside, CA 92505-2612
Phone
(951) 525-3752
NPI assigned
Jul 25, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X CA Primary

Addresses

Primary practice location

4996 La Sierra Ave
Riverside, CA 92505-2612

Mailing address

11409 Garcia CT
Norwalk, CA 90650-5701
Phone (951) 754-6554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1784937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784937600000",
    "number": "1073434809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11409 GARCIA CT",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906505701",
            "telephone_number": "951-754-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4996 LA SIERRA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925052612",
            "telephone_number": "951-525-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "JAE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-07-25",
        "last_updated": "2026-07-25",
        "certification_date": "2026-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.