| Doctor Name: | MR. KENTON JUNG |
| NPI Number: | 1194940759 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.C.S.W. |
| License Number: | LCS4469 |
| Business Practice Address: | 1863 Kashlan Rd La Habra Heights, CA - 906318455 |
| Business Phone Number: | 5626902923 |
| Business Fax Number: | 5626905666 |
| Mailing Address: | 1863 Kashlan Rd, LA HABRA HEIGHTS |
| State: | CA |
| Postal Code: | 906318455 |
| Phone Number: | 5626902923 |
| Fax Number: | 5626905666 |
| NPI Enumeration Date: | 04/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCS4469 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |