Provider Demographics
NPI:1013709872
Name:CHUN, JACOB PAUL (MA, APCC)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:PAUL
Last Name:CHUN
Suffix:
Gender:M
Credentials:MA, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22035 BURBANK BLVD APT 338
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4749
Mailing Address - Country:US
Mailing Address - Phone:805-953-9161
Mailing Address - Fax:
Practice Address - Street 1:30125 AGOURA RD STE F
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4337
Practice Address - Country:US
Practice Address - Phone:424-235-3113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14032101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional