DR. MATTHEW WONG (NPI# 1033343017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033343017 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW WONG |
| Credential | PSY.D |
| Practice Address |
870 Emerald Bay Rd # 303 Box #3 South Lake Tahoe CA 96150-9403 |
| Practice Telephone | 4158060275 |
| Mailing Telephone | 4158060275 |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2016-11-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
26365 | CA | Behavioral Health & Social Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336593771 | Matthew Shao-lin Wong | Student in an Organized Health Care Education/Training Program | 4401 Penn Avenue Suite 3300, Pittsburgh, PA 15224 | 2016-04-22 |
| 1831723337 | Matthew Wong | Behavior Technician | 25201 Paseo De Alicia Ste 110, Laguna Hills, CA 92653-4627 | 2020-02-24 |
| 1578123477 | Matthew Wong | Behavior Technician | 1710 S Amphlett Blvd, San Mateo, CA 94402-2703 | 2019-06-13 |
| 1376020321 | Matthew Wong | Physician Assistant | 5645 Main St, Flushing, NY 11355-5045 | 2018-07-23 |
| 1588187546 | Matthew K Wong | Registered Nurse | 617 W 168th St, New York, NY 10032-3703 | 2017-07-21 |
| 1114457959 | Matthew Wong | Physician Assistant | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2017-06-14 |
| 1356715502 | Matthew Wong | Chiropractor | 1400 N Dutton Ave, Ste 13, Santa Rosa, CA 95401-4657 | 2015-11-25 |
| 1255749222 | Matthew Doc Ming Wong | Pharmacist | 10470 Twin Cities Rd, Galt, CA 95632-9032 | 2014-07-23 |
| 1306101746 | Matthew H Wong | Optometrist | 3553 Whipple Rd, Union City, CA 94587-1507 | 2012-07-11 |
| 1255625620 | Matthew Ling-yu Wong | Student in an Organized Health Care Education/Training Program | 1 Deaconess Rd, W-cc2, Boston, MA 02215-5321 | 2011-06-02 |
| Street Address |
870 EMERALD BAY RD # 303 BOX #3 |
| City | SOUTH LAKE TAHOE |
| State | CA |
| Zip Code | 96150-9403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750818969 | Terri Wong | Behavior Technician | 908 Alameda Ave, #b, South Lake Tahoe, CA 96150 | 2017-05-18 |
| 1154735157 | Catherine Anne Jones | Dental Hygienist | 1088 4th St # 6, South Lake Tahoe, CA 96150 | 2014-06-17 |
| 1245663194 | Sheila Marie Gwin | Behavioral Analyst | 2111south Ave, South Lake Tahoe, CA 96150 | 2013-08-14 |
| 1164785598 | Launa Jean Martin | Doula | 1399 Bozeman Dr, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1881957355 | Elizabeth Marilyn Mcnamara | Emergency Medicine | Barton Memorial Hospital, 2107 South Ave, South Lake Tahoe, CA 96150 | 2012-06-20 |
| 1295034627 | Dana Elizabeth Cox | Chiropractor | 3097 Harrison Ave., # 202, S. Lake Tahoe, CA 96150 | 2011-03-24 |
| 1639485162 | April Lyn Westfall | Dentist | 3358 Sandy Way, # B, S Lake Tahoe, CA 96150 | 2010-08-21 |
| 1700199270 | Rollie E Rohnow | Pharmacist | 1020 Al Tahoe Blvd, Rite Aid Pharmacy, South Lake Tahoe, CA 96150 | 2010-07-26 |
| 1699000455 | Ellen Newell Mccullough | Physical Therapist | 1900 High Meadow Trail, South Lake Tahoe, CA 96150 | 2009-10-13 |
| 1093941148 | Ashley Elizabeth Bedell | Counselor | 1137 Emerald Bay Rd., South Lake Tahoe, CA 96150 | 2009-06-03 |
| Find all providers in zip 96150 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124631312 | Kathleen Carroll-wray | Psychologist | 818 W 7th St Ste 930, Los Angeles, CA 90017-3476 | 2020-08-26 |
| 1568082113 | Laura Adery | Psychologist | 760 Westwood Plz # 27-448, Los Angeles, CA 90095-8353 | 2020-04-23 |
| 1073148938 | Kristine Fleming | Psychologist | 4309 Campbell Dr, Pittsburg, CA 94565-6017 | 2020-03-11 |
| 1730711375 | Benjamin Alpert, Psyd, A Psychological Corporation | Psychologist | 2525 Camino Del Rio S Ste 305 Office2, San Diego, CA 92108-3717 | 2020-02-11 |
| 1073144010 | Melissa Alexis Ramirez | Psychologist | 1514 Caminito Soria Unit 2, Chula Vista, CA 91913-2503 | 2020-01-29 |
| 1063042851 | Making A Difference Association, Inc. | Psychologist | 1430 E Cooley Drive, Ste 111, Colton, CA 92324 | 2020-01-21 |
| 1184264533 | New Vision Counseling Center | Psychologist | 8050 La Mesa Blvd, La Mesa, CA 91942-0335 | 2020-01-14 |
| 1235778614 | Jessica Herbold | Psychologist | 1044 Sir Francis Drake Blvd Ste 7, Kentfield, CA 94904-1454 | 2020-01-02 |
| 1003478405 | Melissa Berrenge-browde | Psychologist | 820 Bay Avenue, Suite 205, Capitola, CA 95010-2102 | 2019-07-05 |
| 1811555840 | Rebecca Cole | Psychologist | 5149 High Meadow Court, Fremont, CA 94536 | 2019-06-04 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH LAKE TAHOE |
| Zip Code | 96150 |
Please comment or provide details below to improve the information on DR. MATTHEW WONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.