Active NPI
Patrick Quinn Jung, BCBA
- Behavior Analyst
- San Ramon, CA
National Provider Identifier
1811241888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-12-12409
- Practice address
- 3180 Crown Canyon Place
#208
San Ramon, CA 94583 - Phone
- (925) 830-8308
- Fax
- (925) 830-8309
- NPI assigned
- Oct 30, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-12-12409 | CA | Primary |
Addresses
Primary practice location
3180 Crown Canyon Place
#208
San Ramon, CA 94583
Mailing address
505 N Brand Blvd
#1000
Glendale, CA 91203-1906
Phone (818) 241-6780
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351555200000",
"number": "1811241888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 N BRAND BLVD",
"address_2": "#1000",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912031906",
"telephone_number": "818-241-6780",
"fax_number": "818-241-6853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3180 CROWN CANYON PLACE",
"address_2": "#208",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "94583",
"telephone_number": "925-830-8308",
"fax_number": "925-830-8309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNG",
"first_name": "PATRICK",
"middle_name": "QUINN",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-30",
"last_updated": "2012-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-12-12409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.