Jiyeon Park, PHD, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

17068 Issued in CA

Practice address

115 Windchime
Irvine, CA 92603-0633

Phone

(949) 689-8236

NPI assigned

Aug 17, 2016

Last updated

Aug 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1225583495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 WINDCHIME",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926030633",
            "telephone_number": "949-689-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WINDCHIME",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926030633",
            "telephone_number": "949-689-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JIYEON",
        "name_prefix": "Dr.",
        "credential": "PHD, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "17068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jae H Park, D.C.
• Jason Hyuk Park, D.P.T.
• Jennifer Park, LMFT
• Jin Hee Park, L.AC.
• Jin Joo Park
• Joann Park
• Kaitlyn Park
• Madison Seong-He Park, DACCHM, LAC
• Mi Ran Park, L.AC.
• Mikyung Park

• Acupuncturist in Irvine, CA
• Providers in Irvine, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.