Jeong Ae Park, LAC, PHD

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC13960 Issued in CA

Practice address

12235 Beach Blvd Ste 115a
Stanton, CA 90680-3942

Phone

(714) 715-4223

Fax

(714) 716-8314

NPI assigned

Sep 19, 2012

Sex

Female

Sole proprietor

Yes

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

Credentials

Doctor of Philosophy

State licenses

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.

• Hope Integrative Acupuncture & Wellness Inc

  • Acupuncturist
  • Stanton, CA
  • NPI 1831055151
  NPD Authorized official
• Jaein Acupuncture & Herbal Medicine, Inc.

  • Acupuncturist
  • Stanton, CA
  • NPI 1689926024
  NPD

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1720338510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8045 RAVENNA LN",
            "city": "STANTON",
            "state": "CA",
            "postal_code": "906803388",
            "telephone_number": "714-715-4223",
            "fax_number": "714-716-8314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12235 BEACH BLVD STE 115A",
            "city": "STANTON",
            "state": "CA",
            "postal_code": "906803942",
            "telephone_number": "714-715-4223",
            "fax_number": "714-716-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JEONG AE",
        "name_prefix": "Dr.",
        "credential": "LAC, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-19",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC13960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayna Padilla
• Debra Padua
• Cryshzel Pajarillo
• Paramount Home Care, Inc.
• Ami Tapan Parikh
• Jessica Park
• Justin Park
• Kyung I. Park, M.D.
• Diana Parmar, MFT
• Violina Iulieta Peapea

• Acupuncturist in Stanton, CA
• Providers in Stanton, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.