Individual provider Active NPI

Anna Jung, MD

  • Psychiatry Physician
  • Daly City, CA
National Provider Identifier
1306181193
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A138221 Issued in CA
Practice address
375 89TH St
Daly City, CA 94015-1802
Phone
(650) 301-8650
NPI assigned
Dec 5, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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 A138221 CA Primary

Addresses

Primary practice location

375 89TH St
Daly City, CA 94015-1802

Mailing address

375 89TH St
Daly City, CA 94015-1802
Phone (650) 301-8650

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
I20161118001634 CA Practitioner - Psychiatry 3870872682 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of California, Davis School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Executive Mental Health, IncGroup PAC ID 0345209102, 47 clinicians

Practice addresses (Care Compare)

11835 W Olympic Blvd
Suite 1270E
Los Angeles, CA 90064-5053
Phone (310) 273-4843

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A138221CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Wu MD PHD Inc Psychiatry CurrentSince Apr 8, 2024 Accepting new patients
San Mateo County Psychiatry CurrentSince Oct 21, 2017 Accepting new patients
County of San Mateo CurrentSince Oct 21, 2017 Accepting new patients
County of San Mateo Current Accepting new patients

Locations

375 89th St
Daly City, CA 94015
Phone (650) 301-8650

11835 W Olympic Blvd
Ste 1270E
Los Angeles, CA 90064
Phone (310) 273-4843

802 Brewster Ave
Redwood City, CA 94063
Phone (650) 363-4111

222 W 39th Ave
San Mateo, CA 94403
Phone (415) 573-2222

1950 Alameda de las Pulgas
San Mateo, CA 94403
Phone (650) 573-3571

16890 Green Tree Blvd
Victorville, CA 92395
Phone (310) 273-4843

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1306181193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 89TH ST",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151802",
            "telephone_number": "650-301-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 89TH ST",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151802",
            "telephone_number": "650-301-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "ANNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-05",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A138221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.