Klancy J Chung, REGISTERED AMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

133954 Issued in CA

Practice address

5755 Oberlin Dr Ste 106
San Diego, CA 92121-4715

Phone

(619) 736-0436

NPI assigned

Jan 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1205425337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 RAYMELL DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921233544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 OBERLIN DR STE 106",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921214715",
            "telephone_number": "619-736-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "KLANCY",
        "middle_name": "J",
        "credential": "REGISTERED AMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2024-07-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "812817",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "133954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Soon Chung, M.D.
• Jonathan Hero Chung
• Joyce W. Chung, M.D.
• Junhee Chung
• Kiyon Chung, MD
• Lena Chung, PMHNP-BC
• Michelle Sheryl Chung, MD
• Robert Chung
• Soyeon Karen Chung, PH.D.
• Suemin Chung, PMHNP-BC

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.