Jonathan Michael Park

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-22-216311 Issued in CA

Practice address

1601 New Stine Rd Ste 195
Bakersfield, CA 93309-3699

Phone

(661) 563-9392

NPI assigned

Oct 18, 2022

Last updated

Oct 18, 2022By the provider in NPPES

Sex

Male

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

State licenses

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1720704034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 SAN LUCAS DR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933076858",
            "telephone_number": "661-563-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 NEW STINE RD STE 195",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933093699",
            "telephone_number": "661-563-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-22-216311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyun-Joo Keri Park, PA-C
• Jae Hyun Park
• Jee Woo Park
• Jieun Park
• Joanne J Park, RPH
• Kiefer Sungwhan Park, DDS
• Kyoung Hee Park
• Kyung Choon Park, O.D.
• Nathaniel Jeong Su Park
• Woori Park

• Behavior Technician in Bakersfield, CA
• Providers in Bakersfield, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.