Tyson Chung, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY22820 Issued in CA

Practice address

26001 Redlands Blvd
Redlands, CA 92373-7762

Phone

(800) 741-8387

NPI assigned

Feb 16, 2007

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Pacific Clinics

  • Community/Behavioral Health Agency
  • Irwindale, CA
  • NPI 1821495003
  NPD (past)
• Pacific Clinics

  • Community/Behavioral Health Agency
  • Ontario, CA
  • NPI 1902273923
  NPD (past)
• Persona Neuro Behavior Group Inc.

  • Clinical Neuropsychologist
  • South Pasadena, CA
  • NPI 1881798171
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1346384286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8191",
            "city": "LA VERNE",
            "state": "CA",
            "postal_code": "917508191",
            "telephone_number": "626-641-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26001 REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923737762",
            "telephone_number": "800-741-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 Fair Oaks Ave Ste 390",
            "address_purpose": "LOCATION",
            "city": "South Pasadena",
            "state": "CA",
            "postal_code": "910305817",
            "country_code": "US",
            "telephone_number": "800-314-7273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "TYSON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY22820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Key Chung, RPH
• Casey Chung
• Pooreum Clara Chung
• Sae Hwan Chung, DDS
• Sunghyun Chung, MD
• Young Woong Chung, DDS
• Danae Marie Ciesla
• Robert A Cimini, M.D.
• Megan A Cintron, SLPA
• Antonia Ciovica, PH.D.

• Clinical Psychologist in Redlands, CA
• Providers in Redlands, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.