Active NPI
Edmond Chung
- Behavior Technician
- Newark, CA
National Provider Identifier
1134859317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 39899 Balentine Dr Ste 110
Newark, CA 94560-5356 - Phone
- (855) 223-7123
- Fax
- (619) 374-7134
- NPI assigned
- Jun 12, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
39899 Balentine Dr Ste 110
Newark, CA 94560-5356
Mailing address
PO Box 33568
San Diego, CA 92163-3568
Phone (855) 223-7123
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": "1654992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764028800000",
"number": "1134859317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33568",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921633568",
"telephone_number": "855-223-7123",
"fax_number": "113-485-9317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39899 BALENTINE DR STE 110",
"city": "NEWARK",
"state": "CA",
"postal_code": "945605356",
"telephone_number": "855-223-7123",
"fax_number": "619-374-7134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "EDMOND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-12",
"last_updated": "2025-11-25",
"certification_date": "2025-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.