Jessica Chung Mac, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

119283 Issued in CA

Practice address

253 S Diamond Bar Blvd
Diamond Bar, CA 91765-1606

Phone

(909) 860-1144

NPI assigned

Jul 21, 2017

Last updated

Apr 23, 2025By 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

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1326561382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4365 IRONWOOD AVE",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 S DIAMOND BAR BLVD",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917651606",
            "telephone_number": "909-860-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAC",
        "first_name": "JESSICA",
        "middle_name": "CHUNG",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-21",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "119283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle Lucas, M.D.
• Luma Care Behavioral Health LLC
• D Carol Lynch, PH.D.
• Diana Marie Lynn, D.P.T.
• M&M NP, Inc.
• Kenneth Steven Machado, D.C.
• Rebecca C Mak, PHARM. D
• Simon Mak
• Rachael O Maldonado, NP
• Natalie Manorothkul

• Clinical Social Worker in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.