Individual provider Active NPI

Rose Mae Pavino Chung, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Torrance, CA
National Provider Identifier
1710314323
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95027772 Issued in CA
Practice address
2780 Skypark Dr Ste 202
Torrance, CA 90505-5399
Phone
(855) 501-1004
NPI assigned
Sep 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 791980 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95027772 CA Primary

Addresses

Primary practice location

2780 Skypark Dr Ste 202
Torrance, CA 90505-5399

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954

Other practice location 1

3333 Skypark Dr Ste 220
Torrance, CA 90505-5035
Phone (855) 427-2778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240902000258 CA Practitioner - Nurse Practitioner 0446799613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2780 Skypark Dr
Suite 202
Torrance, CA 90505-5399
Phone (310) 257-5750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
791980CAMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mark David Levine M.D. Professional Corporation Psychiatric/Mental Health CurrentSince Aug 20, 2024 Accepting new patients
Mark David Levine, MD Burlingame PC CurrentSince Aug 20, 2024 Accepting new patients

Locations

4553 Glencoe Ave
Ste 315
Marina del Rey, CA 90292

3835 N Freeway Blvd
Ste 100
Sacramento, CA 95834
Phone (916) 576-7898

3333 Skypark Dr
Ste 220
Torrance, CA 90505
Phone (310) 257-5750

Organizations & group practices 2

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": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1710314323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 SKYPARK DR STE 202",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055399",
            "telephone_number": "855-501-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 Skypark Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905055035",
            "country_code": "US",
            "telephone_number": "855-427-2778",
            "fax_number": "310-257-5753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "ROSE MAE",
        "middle_name": "PAVINO",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "791980",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95027772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.