Individual provider Active NPI

Jung Mee Won, MFT

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1427771815
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
130961 Issued in CA
Practice address
3880 S Bascom Ave Ste 115
San Jose, CA 95124-2600
Phone
(408) 351-1044
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 130961 CA Primary

Addresses

Primary practice location

3880 S Bascom Ave Ste 115
San Jose, CA 95124-2600

Mailing address

3880 S Bascom Ave Ste 115
San Jose, CA 95124-2600
Phone (408) 351-1044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 10, 2024 through Jul 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Child & Family Counseling Group Marriage & Family Therapist CurrentSince Sep 25, 2022 Accepting new patients

Locations

3880 S Bascom Ave
Ste 115
San Jose, CA 95124
Phone (408) 351-1044

Organizations & group practices 1

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": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1427771815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 115",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242600",
            "telephone_number": "408-351-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 115",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242600",
            "telephone_number": "408-351-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WON",
        "first_name": "JUNG",
        "middle_name": "MEE",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "130961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.