Active NPI
Christine Jee Park, LMFT
- Marriage & Family Therapist
- Long Beach, CA
National Provider Identifier
1124438080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 119031
- Practice address
- 5150 E. Pacific Coast Highway
Suite 200
Long Beach, CA 90804 - Phone
- (562) 452-0435
- NPI assigned
- Apr 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 119031 | CA | Primary |
| Marriage & Family Therapist | 106H00000X |
Addresses
Primary practice location
5150 E. Pacific Coast Highway
Suite 200
Long Beach, CA 90804
Mailing address
5150 E. Pacific Coast Highway
Suite 200
Long Beach, CA 90804
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119031 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childnet Youth and Family Services Inc | Past | Accepting new patients | |
| Allyson Wells MD Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Child & Adolescent Psychiatry Physician
- Long Beach, CA
- NPI 1770181257
-
- Community/Behavioral Health Agency
- Long Beach, CA
- NPI 1760519219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1124438080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5150 E. PACIFIC COAST HIGHWAY",
"address_2": "SUITE 200",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5150 E. PACIFIC COAST HIGHWAY",
"address_2": "SUITE 200",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90804",
"telephone_number": "562-452-0435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "CHRISTINE",
"middle_name": "JEE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-30",
"last_updated": "2025-01-14",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "119031",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.