Mikyung Park

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-14-9888 Issued in CA

Practice address

16782 Von Karman Ave Ste 11
Irvine, CA 92606-2417

Phone

(855) 223-7123

Fax

(619) 734-7134

NPI assigned

Feb 10, 2016

Sex

Female

Sole proprietor

No

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)

Not enrolled

Practice roles

Locations

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.

• Center for Spectrum CL LLC

  • Behavior Analyst
  • Houston, TX
  • NPI 1477268290
  NPD Authorized official
• Center for Spectrum LLC

  • Behavior Analyst
  • Katy, TX
  • NPI 1770175200
  NPD Authorized official

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513814400000",
    "number": "1639537210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "855-223-7123",
            "fax_number": "619-734-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "855-223-7123",
            "fax_number": "619-734-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "MIKYUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2017-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-14-9888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joann Park
• Justin Jong-Gene Park, MD
• Kaitlyn Park
• Madison Seong-He Park, DACCHM, LAC
• Mi Ran Park, L.AC.
• Moonjoo Park
• Sarah Park
• SE J Park, NP-C, DNP
• So Y Park, L.AC.
• Sunmin Park

• Behavior Analyst in Irvine, CA
• Providers in Irvine, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.