Individual provider Active NPI

Connie Ju-Hye Chung, FNP-BC

  • Family Nurse Practitioner
  • Anaheim, CA
National Provider Identifier
1902414691
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95012347 Issued in CA
Practice address
1325 N Anaheim Blvd # 200
Anaheim, CA 92801-1202
Phone
(888) 499-9303
Fax
(888) 499-9303
NPI assigned
Jul 19, 2020
Last updated
Apr 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95012347 CA Primary

Addresses

Primary practice location

1325 N Anaheim Blvd # 200
Anaheim, CA 92801-1202

Mailing address

1325 N Anaheim Blvd # 200
Anaheim, CA 92801-1202
Phone (888) 499-9303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230330002244 CA Order and Referring Only - Nurse Practitioner 0547633414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1595116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1902414691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 N ANAHEIM BLVD # 200",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011202",
            "telephone_number": "888-499-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 N ANAHEIM BLVD # 200",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011202",
            "telephone_number": "888-499-9303",
            "fax_number": "888-499-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "CONNIE",
        "middle_name": "JU-HYE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-19",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95012347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.