Provider Demographics
NPI:1225921927
Name:RHEE, JENNIFER SANGSOOK
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SANGSOOK
Last Name:RHEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 FAIRMEADE RD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3014
Mailing Address - Country:US
Mailing Address - Phone:818-314-4436
Mailing Address - Fax:
Practice Address - Street 1:3610 FAIRMEADE RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3014
Practice Address - Country:US
Practice Address - Phone:818-314-4436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-31
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC19455101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health