Active NPI
Jaclyn Sue Schunk, MA
- Marriage & Family Therapist
- Long Beach, CA
National Provider Identifier
1154446730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 48282
- Practice address
- 4565 California Ave
Long Beach, CA 90807-1507 - Phone
- (562) 422-8472
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 48282 | CA | Primary |
Addresses
Primary practice location
4565 California Ave
Long Beach, CA 90807-1507
Mailing address
4565 California Ave.
Long Beach, CA 90807
Phone (562) 422-8472
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 48282 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288310400000",
"number": "1154446730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4565 CALIFORNIA AVE.",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90807",
"telephone_number": "562-422-8472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4565 CALIFORNIA AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908071507",
"telephone_number": "562-422-8472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHUNK",
"first_name": "JACLYN",
"middle_name": "SUE",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2010-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 48282",
"primary": true
}
],
"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 Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.