Provider Demographics
NPI:1467252379
Name:SMILE SQUARED PSYCHIATRY, A NURSING PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:SMILE SQUARED PSYCHIATRY, A NURSING PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUNG HWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HYUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-303-2869
Mailing Address - Street 1:10966 ROCHESTER AVE APT 405
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6272
Mailing Address - Country:US
Mailing Address - Phone:517-303-2869
Mailing Address - Fax:
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:517-303-2869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty