Sungju Park

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW127687 Issued in CA

Practice address

2035 E Ball Rd Ste 100&200
Anaheim, CA 92806-5159

Phone

(714) 517-6300

NPI assigned

Nov 17, 2023

Last updated

Feb 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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.

• County of Orange

  dba Health Care Agency

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Santa Ana, CA
  • NPI 1104963347
  Medicare reassignment NPD
• Soultenders, Inc.

  • Clinical Psychologist
  • Arcadia, CA
  • NPI 1164617007
  Medicare reassignment NPD
• County of Orange

  dba BHS-Sud-Av

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Aliso Viejo, CA
  • NPI 1457574683
  NPD
• County of Orange

  dba AMHS Crisis Stabilization Unit

  • Adult Mental Health Clinic/Center
  • Santa Ana, CA
  • NPI 1598025793
  NPD

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1336914639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 E BALL RD STE 100&200",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928065159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 E BALL RD STE 100&200",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928065159",
            "telephone_number": "714-517-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SUNGJU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-17",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW127687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert J. Park, MD
• Sangwon James Park, RPH
• Sarah Park
• Soon Lim Park, ACUPUNCTURIST
• Sung-Un Justin Park, MD
• Sungmin Park, L.AC.
• Tiffany Park, OD, MS
• Tiffany Park, MD
• Timothy C Park, DDS
• Younghee Park, CCC-SLP

• Clinical Social Worker in Anaheim, CA
• Providers in Anaheim, 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 Feb 3, 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.