Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jeoung P Park, PSYCHOLOGIST

Individual provider Clinical Psychologist · NPI 1578723805

Dr. Jeoung P Park, PSYCHOLOGIST is a Clinical Psychologist in Fresno, California. Qualified in 2013, 13 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
13
Licensed in
CA
In the registry since
2008
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Practice location Address checks out

1357 W Shaw Ave Ste 104
Fresno, CA 93711-3619
Phone: (559) 970-4812
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4460 W Shaw Ave # 555, Fresno, CA 93722-6210 — (559) 492-6689

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY29775 (CA)

Record details

NPI number1578723805
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYCHOLOGIST
Sole proprietorYes
NPI enumeratedJune 10, 2008
Last updated in NPPESSeptember 10, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fresno