Individual provider Active NPI

Justin Jung

  • Counselor
  • San Francisco, CA
National Provider Identifier
1609248400
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
ASW73069 Issued in CA
Practice address
1500 Mission St
San Francisco, CA 94103-2513
Phone
(415) 200-9488
NPI assigned
Oct 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X ASW73069 CA Primary

Addresses

Primary practice location

1500 Mission St
San Francisco, CA 94103-2513

Mailing address

1735 Mission St
San Francisco, CA 94103-2417
Phone (415) 762-3700

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

State licenses

LicenseStateTypeSpecialty
ASW73069CAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1609248400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032417",
            "telephone_number": "415-762-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032513",
            "telephone_number": "415-200-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNG",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-20",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "ASW73069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.