Individual provider Active NPI

Jung in Park

  • Behavior Analyst
  • Santa Ana, CA
National Provider Identifier
1164063616
Registry record updated Apr 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-59122 Issued in CA
Practice address
555 Parkcenter Dr Ste 115
Santa Ana, CA 92705-3521
Phone
(714) 310-4377
NPI assigned
Oct 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-22-59122 CA Primary

Addresses

Primary practice location

555 Parkcenter Dr Ste 115
Santa Ana, CA 92705-3521

Mailing address

555 Parkcenter Dr Ste 115
Santa Ana, CA 92705-3521
Phone (714) 310-4377

Other practice location 1

2573 Coventry Cir
Fullerton, CA 92833-1263
Phone (615) 829-2937

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Behavior Consultants Behavior Analyst PastSince Aug 6, 2023 Accepting new patients
Spectrum Behavioral Solutions, LLC Behavior Analyst PastSince Oct 1, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775347200000",
    "number": "1164063616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 PARKCENTER DR STE 115",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053521",
            "telephone_number": "714-310-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 PARKCENTER DR STE 115",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053521",
            "telephone_number": "714-310-4377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2573 Coventry Cir",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928331263",
            "country_code": "US",
            "telephone_number": "615-829-2937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "JUNG IN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2026-04-05",
        "certification_date": "2026-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-22-59122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.