Individual provider Active NPI

Hyeyoung Jung, LCSW

  • Clinical Social Worker
  • Diamond Bar, CA
National Provider Identifier
1255829479
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW79621 Issued in CA
Practice address
3333 S Brea Canyon Rd
Ste 107
Diamond Bar, CA 91765-3782
Phone
(323) 823-8563
NPI assigned
Apr 24, 2018
Last updated
Feb 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW79621 CA Primary

Addresses

Primary practice location

3333 S Brea Canyon Rd
Ste 107
Diamond Bar, CA 91765-3782

Mailing address

2271 W Malvern Ave # 319
Fullerton, CA 92833-2106
Phone (323) 823-8563

Other names 1

  • Jasmine Jung Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022004580 CA Practitioner - Clinical Social Worker 0042743536 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW79621CAMDClinical Social Worker
79621CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Clinical CurrentSince Sep 18, 2024 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1255829479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2271 W MALVERN AVE # 319",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928332106",
            "telephone_number": "323-823-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S BREA CANYON RD",
            "address_2": "STE 107",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917653782",
            "telephone_number": "323-823-8563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "HYEYOUNG",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2024-02-12",
        "certification_date": "2023-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW79621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASMINE",
            "last_name": "JUNG",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Diamond Bar, CA

Sources for this page

Verify at the official NPI Registry.