Provider Demographics
NPI:1497373500
Name:PARADIGM PSYCHIATRY
Entity type:Organization
Organization Name:PARADIGM PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIONGLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:480-613-9599
Mailing Address - Street 1:90 S KYRENE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-4687
Mailing Address - Country:US
Mailing Address - Phone:480-613-9599
Mailing Address - Fax:480-900-8515
Practice Address - Street 1:90 S KYRENE RD STE 4
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-4687
Practice Address - Country:US
Practice Address - Phone:480-415-9305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)