Individual provider Active NPI

Mi Joung Park

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1104465426
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
141130 Issued in CA
Practice address
3727 W 6TH St Ste 402
Los Angeles, CA 90020-5112
Phone
(213) 365-7400
NPI assigned
Jan 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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 141130 CA Primary

Addresses

Primary practice location

3727 W 6TH St Ste 402
Los Angeles, CA 90020-5112

Mailing address

265 S Western Ave Unit 743172
Los Angeles, CA 90004-4749

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": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1104465426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 S WESTERN AVE UNIT 743172",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900044749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 W 6TH ST STE 402",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900205112",
            "telephone_number": "213-365-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MI JOUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-03",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "141130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; 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.