Active NPI
Jakyung Park
- Occupational Therapist
- Chino, CA
National Provider Identifier
1942629068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT11381
- Practice address
- 13461 Ramona Ave
Chino, CA 91710-5029 - Phone
- (909) 628-1201
- NPI assigned
- Apr 16, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT11381 | CA | Primary |
Addresses
Primary practice location
13461 Ramona Ave
Chino, CA 91710-5029
Mailing address
13461 Ramona Ave
Chino, CA 91710-5029
Phone (909) 628-1201
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT11381 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pristine Rehabcare, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Early Intervention Provider Agency
- Diamond Bar, CA
- NPI 1518258532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778025600000",
"number": "1942629068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13461 RAMONA AVE",
"city": "CHINO",
"state": "CA",
"postal_code": "917105029",
"telephone_number": "909-628-1201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13461 RAMONA AVE",
"city": "CHINO",
"state": "CA",
"postal_code": "917105029",
"telephone_number": "909-628-1201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "JAKYUNG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-16",
"last_updated": "2026-05-06",
"certification_date": "2026-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "OT11381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.