Provider Demographics
NPI:1386969202
Name:JUNG, YI JIN JIN (LAC)
Entity type:Individual
Prefix:
First Name:YI JIN
Middle Name:JIN
Last Name:JUNG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 F ST.
Mailing Address - Street 2:SUITE F 11
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301
Mailing Address - Country:US
Mailing Address - Phone:661-434-3415
Mailing Address - Fax:888-498-7692
Practice Address - Street 1:2920 F. ST.
Practice Address - Street 2:SUITE F 11
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301
Practice Address - Country:US
Practice Address - Phone:661-434-3415
Practice Address - Fax:888-498-7692
Is Sole Proprietor?:No
Enumeration Date:2010-04-03
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13318171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist