DR. JEOUNG P PARK PSYCHOLOGIST
NPI 1578723805
Psychologist - Clinical in Fresno, CA

Active since June 10, 2008PECOS EnrolledAccepts Medicare Assignment
1357 W SHAW AVE, STE 104, FRESNO, CA 93711(559) 970-4812 Get Directions Write a Review

NPPES record last updated: September 10, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 10, 2018, Sep 7, 2018 (2 updates tracked since 2018).

About Dr. Jeoung P Park Psychologist NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JEOUNG P PARK PSYCHOLOGIST (NPI 1578723805) is an individual clinical provider in Fresno, California, licensed in California (PSY29775) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, maintains a secondary practice location in Fresno, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1578723805
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JEOUNG P PARKCredential: PSYCHOLOGIST
Location Address1357 W SHAW AVE, STE 104Fresno, CA 93711-3619
Mailing Address4460 W Shaw Ave # 555Fresno, CA 93722-6210 · (559) 492-6689
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateJune 10, 2008
Last NPPES UpdateSeptember 10, 20182 updates tracked since enumeration
NPI 1578723805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License Licensed in CA · PSY29775
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

1357 W SHAW AVE, Fresno, CA 93711

Secondary Practice Location 1

Location 14460 W Shaw Ave # 555Fresno, CA 93722-6210 · Phone (559) 492-6689

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Jeoung P Park Psychologist is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880930726
PECOS Enrollment IDI20190114001337
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
219 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93711 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$176.60 typical visit price
range $58.87 – $176.60
Typical copayment $44.15 (range $14.71 – $44.15)
Most-billed visit code 99205
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Physical Therapy)
1357 W SHAW AVE, SUITE 101
FRESNO, CA 93711
Psychologist (Clinical)
1357 W SHAW AVE, SUITE 104
FRESNO, CA 93711
Social Worker (Clinical)
1357 W SHAW AVE, SUITE 104
FRESNO, CA 93711
Chiropractor
1357 W SHAW AVE, 103
FRESNO, CA 93711
Physical Therapist
1357 W SHAW AVE, SUITE 101
FRESNO, CA 93711
Psychologist (Clinical)
1357 W SHAW AVE, SUITE 104
FRESNO, CA 93711
Obstetrics & Gynecology (Hospice and Palliative Medicine)
1357 W SHAW AVE, STE.103
FRESNO, CA 93711

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeoung Park's NPI number?

The NPI number for Jeoung Park is 1578723805. It was assigned to this individual provider in the NPPES registry on June 10, 2008.

Where is Jeoung Park located?

Jeoung Park practices at 1357 W Shaw Ave Ste 104, Fresno, CA 93711. The listed phone number is (559) 970-4812.

What is Jeoung Park's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Jeoung Park enrolled in Medicare?

Yes. Jeoung Park is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jeoung Park accept?

Health plans from Providence Health Plan list Jeoung Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jeoung Park was last updated on September 10, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.