Individual provider Active NPI

Heanh Socheata Kung, MSW

  • Clinical Social Worker
  • Long Beach, CA
National Provider Identifier
1396099123
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
88001 Issued in CA
Practice address
3530 Atlantic Ave Ste 210
Long Beach, CA 90807-4569
Phone
(714) 343-4056
NPI assigned
Oct 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 34802 CA
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X
Rehabilitation PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 225400000X
Clinical Social Worker 1041C0700X 88001 CA Primary

Addresses

Primary practice location

3530 Atlantic Ave Ste 210
Long Beach, CA 90807-4569

Mailing address

3530 Atlantic Ave
Suite 210
Long Beach, CA 90807-4569
Phone (562) 424-1886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1396099123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 ATLANTIC AVE",
            "address_2": "SUITE 210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074569",
            "telephone_number": "562-424-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 ATLANTIC AVE STE 210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074569",
            "telephone_number": "714-343-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNG",
        "first_name": "HEANH",
        "middle_name": "SOCHEATA",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "34802",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "88001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.