Stacy Park

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCS23522 Issued in CA

Practice address

1730 W Olympic Blvd FL 3a-100
Los Angeles, CA 90015-1019

Phone

(213) 553-1884

Fax

(213) 236-9662

NPI assigned

Aug 6, 2008

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1992961197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 W OLYMPIC BLVD FL 3A-100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151019",
            "telephone_number": "213-236-9394",
            "fax_number": "213-236-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 W OLYMPIC BLVD FL 3A-100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151019",
            "telephone_number": "213-553-1884",
            "fax_number": "213-236-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "STACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS23522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soonju Park
• Sooyoung Park, MSW
• Sophia Anne Park, MD
• Soyun Park, MD
• Stacey Park
• Stella Park
• Stephen Jin Park, DDS
• Stephen Joon Park
• Steve Seekook Park, M.D.
• Sue Park, MD

• Clinical Social Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.