Individual provider Active NPI

Hannah Chung

  • Occupational Therapist
  • San Gabriel, CA
National Provider Identifier
1821665456
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
20549 Issued in CA
Practice address
1788 S San Gabriel Blvd Ste 101
San Gabriel, CA 91776-3978
Phone
(626) 656-6253
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 20549 CA Primary

Addresses

Primary practice location

1788 S San Gabriel Blvd Ste 101
San Gabriel, CA 91776-3978

Mailing address

1788 S San Gabriel Blvd Ste 101
San Gabriel, CA 91776-3978
Phone (626) 656-6253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210617003105 CA Practitioner - Occupational Therapist in Private Practice 5799185336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wynk'S CorporationGroup PAC ID 5294107256, 2 clinicians

Practice addresses (Care Compare)

1788 S San Gabriel Blvd
Suite 101
San Gabriel, CA 91776-3978
Phone (626) 656-6253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20549CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wynk'S Corporation CurrentSince Nov 9, 2024 Accepting new patients
Wynk'S Clinic CurrentSince Nov 9, 2024 Accepting new patients
Feld Care Therapy Inc Occupational Therapist Past Accepting new patients

Locations

1788 S San Gabriel Blvd
Ste 101
San Gabriel, CA 91776
Phone (626) 656-6253

1806 S San Gabriel Blvd
San Gabriel, CA 91776
Phone (626) 377-0515

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1821665456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1788 S SAN GABRIEL BLVD STE 101",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763978",
            "telephone_number": "626-656-6253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1788 S SAN GABRIEL BLVD STE 101",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763978",
            "telephone_number": "626-656-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "HANNAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "20549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.