Munju Anna Chung

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114974 Issued in CA

Practice address

8624 White Rd
Phelan, CA 92371-6594

Phone

(818) 216-3631

NPI assigned

Sep 22, 2020

Last updated

May 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: mchung@pacificclinics.org

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1720694987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8624 WHITE RD",
            "city": "PHELAN",
            "state": "CA",
            "postal_code": "923716594",
            "telephone_number": "818-216-3631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8624 WHITE RD",
            "city": "PHELAN",
            "state": "CA",
            "postal_code": "923716594",
            "telephone_number": "818-216-3631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3881 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900621105",
            "country_code": "US",
            "telephone_number": "626-528-1103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "MUNJU",
        "middle_name": "ANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "114974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mchung@pacificclinics.org",
            "affiliation": "N",
            "address_1": "3881 S Western Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900621105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Joshua Wayne Clark
• Kristianna Mercedes Clark, PPS
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• Cierra Crampton, MS
• D J a M Inc (Phelan Family Pharmacy)

• Clinical Social Worker in Phelan, CA
• Providers in Phelan, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.