Provider Demographics
NPI:1467756924
Name:PARK, HYUNG KYUNG
Entity Type:Individual
Prefix:
First Name:HYUNG KYUNG
Middle Name:
Last Name:PARK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:
Other - Last Name:PARK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9261 FOLSOM BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2560
Mailing Address - Country:US
Mailing Address - Phone:916-363-1553
Mailing Address - Fax:916-363-1638
Practice Address - Street 1:9261 FOLSOM BLVD STE 500
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2560
Practice Address - Country:US
Practice Address - Phone:916-363-1553
Practice Address - Fax:916-363-1638
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health