Active NPI
Dennis Ming Tak Chung, PH.D., BCBA-D
- Clinical Psychologist
- Fremont, CA
National Provider Identifier
1497069215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY25206
- Practice address
- 3775 Beacon Ave
Suite 208
Fremont, CA 94538-1465 - Phone
- (510) 449-3386
- NPI assigned
- Aug 4, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Clinical Psychologist | 103TC0700X | PSY25206 | CA | Primary |
Addresses
Primary practice location
3775 Beacon Ave
Suite 208
Fremont, CA 94538-1465
Mailing address
3775 Beacon Ave
Suite 208
Fremont, CA 94538-1465
Phone (510) 449-3386
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY25206 | CA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Motivation Confidence Achievement Corporation | Behavior Analyst | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba MCA Corporation
- Clinical Psychologist
- Fremont, CA
- NPI 1376707141
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465344000000",
"number": "1497069215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3775 BEACON AVE",
"address_2": "SUITE 208",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381465",
"telephone_number": "510-449-3386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3775 BEACON AVE",
"address_2": "SUITE 208",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381465",
"telephone_number": "510-449-3386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "DENNIS MING TAK",
"name_prefix": "Dr.",
"credential": "PH.D., BCBA-D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-04",
"last_updated": "2016-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY25206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.