Provider Demographics
NPI:1326827171
Name:HYUN, JUNG HWAN (MSN, PMHNP)
Entity type:Individual
Prefix:
First Name:JUNG HWAN
Middle Name:
Last Name:HYUN
Suffix:
Gender:
Credentials:MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 WESTWOOD BLVD STE 2B
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4951
Mailing Address - Country:US
Mailing Address - Phone:747-226-4842
Mailing Address - Fax:747-203-0374
Practice Address - Street 1:1334 WESTWOOD BLVD STE 2B
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4951
Practice Address - Country:US
Practice Address - Phone:747-226-4842
Practice Address - Fax:747-203-0374
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95343067163W00000X
CA95029248363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse