Individual provider Active NPI

Myung Ju Ji, AMFT

  • Marriage & Family Therapist
  • Fullerton, CA
National Provider Identifier
1689551095
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
148598 Issued in CA
Practice address
3031 Colt Way Unit 231
Fullerton, CA 92833-4943
Phone
(703) 399-9764
NPI assigned
Aug 18, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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 148598 CA Primary

Addresses

Primary practice location

3031 Colt Way Unit 231
Fullerton, CA 92833-4943

Mailing address

321 S State College Blvd
Anaheim, CA 92806-4118
Phone (703) 399-9764

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
148598CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1689551095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 S STATE COLLEGE BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928064118",
            "telephone_number": "703-399-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 COLT WAY UNIT 231",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334943",
            "telephone_number": "703-399-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JI",
        "first_name": "MYUNG",
        "middle_name": "JU",
        "name_prefix": "Mrs.",
        "credential": "AMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "148598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.