Individual provider Active NPI

Jane Yeoun Chung, M.D.

  • Psychiatry Physician
  • Visalia, CA
National Provider Identifier
1265519441
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
G63039 Issued in CA
Practice address
520 E Tulare Ave
Visalia, CA 93292-3629
Phone
(559) 788-1200
NPI assigned
Nov 1, 2006
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X G63039 CA Primary

Addresses

Primary practice location

520 E Tulare Ave
Visalia, CA 93292-3629

Mailing address

4843 Commonwealth Ave
La Canada, CA 91011-2506
Phone (818) 952-2614

Other identifiers 1

IdentifierTypeStateIssuer
G63039OtherCALICENSE

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101014001469 CA Practitioner - Psychiatry 3577756105 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G63039CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Jul 1, 2020 Accepting new patients
La Mer Psychiatric Medical Group, Inc. Past Accepting new patients

Locations

10333 El Camino Real
Atascadero, CA 93422
Phone (805) 468-2000

11401 Bloomfield Ave
Norwalk, CA 90650
Phone (562) 863-7011

1600 9th St
Ste 150
Sacramento, CA 95814
Phone (916) 651-8811

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Organizations & group practices 3

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1265519441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4843 COMMONWEALTH AVE",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910112506",
            "telephone_number": "818-952-2614",
            "fax_number": "805-388-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E TULARE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932923629",
            "telephone_number": "559-788-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JANE",
        "middle_name": "YEOUN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G63039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "G63039",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.