Charissa Mamie Jung

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

6711 Issued in CA

Practice address

39675 Cedar Blvd Ste 260
Newark, CA 94560-5364

Phone

(510) 877-0686

NPI assigned

Jul 14, 2025

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• K.D. Speech Pathology & Developmental Services, Inc.

  • Speech-Language Pathologist
  • Newark, CA
  • NPI 1396077095
  NPD (past)

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

{
    "created_epoch": "1752451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1164313458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39675 CEDAR BLVD STE 260",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945605364",
            "telephone_number": "510-877-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39675 CEDAR BLVD STE 260",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945605364",
            "telephone_number": "510-877-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "CHARISSA",
        "middle_name": "MAMIE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-07-14",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "CA",
            "license": "6711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Jones
• Kenneth R. Jones
• Talise Yasmin Jovel
• Judy Nguyen, OD, Inc.
• Judy T. Nguyen, OD
• Fatima Justiniano, D.D.S.
• K.D. Speech Pathology & Developmental Services, Inc.
• Hiba Kaleem
• Emily Kamalnathan
• Aditya Kancharla

• Speech-Language Assistant in Newark, CA
• Providers in Newark, CA by specialty
• Speech-Language Assistant in California

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

Verify at the official NPI Registry.