Elizabeth Sung Park

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122316 Issued in CA

Practice address

1230 Rosecrans Ave Ste 300
Manhattan Beach, CA 90266-2494

Phone

(310) 561-1008

NPI assigned

Mar 29, 2022

Last updated

Mar 29, 2022By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TML Behavioral Health Group LLC

  dba TML Villa Canyon

  • Psychiatric Residential Treatment Facility
  • Castaic, CA
  • NPI 1003661737
  NPD

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1770223869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 FAIRWAY AVE",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201407",
            "telephone_number": "213-800-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 ROSECRANS AVE STE 300",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902662494",
            "telephone_number": "310-561-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ELIZABETH",
        "middle_name": "SUNG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palmer Chiropractic
• Christopher L Palmer, D.C.
• Alexander Panis, NP
• Patricia J Panucci, DMD, MS
• Cristy A Pareti, PSYD, LMFT
• Karen A Passey I, MPT
• Patel Spine Care Medical Inc (Ocean Spine)
• Divya Pansuria Patel
• Pranay Patel, M.D.
• Rosalie Patel, PHARM.D.

• Marriage & Family Therapist in Manhattan Beach, CA
• Providers in Manhattan Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.