DR. VIDA WONG (NPI# 1083783062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083783062 |
| Entity Type | Individual |
| Full Name | DR. VIDA WONG |
| Credential | PSY.D. |
| Practice Address |
5674 Stoneridge Dr Ste 218 Pleasanton CA 94588 |
| Mailing Address |
5674 Stoneridge Dr Ste 218 Pleasanton CA 94588-8532 |
| Practice Telephone | 9253076563 |
| Mailing Telephone | 9253076563 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2019-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY30874 | CA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 39210 State St Ste 109, Fremont, CA 945381456 | 5108180892 | |
| 310 8th St, Oakland, CA 946076526 | 5108696043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437532439 | Vida Wong | Nurse Practitioner | 4334b White Plains Rd, Bronx, NY 10466-3097 | 2015-07-08 |
| Street Address |
5674 STONERIDGE DR STE 218 |
| City | PLEASANTON |
| State | CA |
| Zip Code | 94588 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851641765 | Dale Siperstein | Psychologist | 5674 Stoneridge Dr Ste 218, Pleasanton, CA 94588-8532 | 2012-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932786 | Kabafusion, LLC | Durable Medical Equipment & Medical Supplies | 5860 W. Las Positas Blvd, Suite 19, Pleasanton, CA 94588 | 2020-11-02 |
| 1619519691 | Vanessa Baldwin | Behavior Technician | 5828 Stoneridge Mall Road, Suit 205, Pleasanton, CA 94588 | 2019-10-11 |
| 1184187783 | Amanda Singh | Behavior Technician | 1811 Stoneridge Mall Rd Suite 205, Pleasanton, CA 94588 | 2019-04-10 |
| 1891262192 | Virginia Zamora | Behavior Technician | 5820 Stoneridgemall Rd, Suite 205, Pleasanton, CA 94588 | 2018-10-25 |
| 1891275368 | Ixchel N Baltazar | Behavioral Analyst | 520 Stoneridge Mall Rd, Ste. 205, Pleasanton, CA 94588 | 2018-08-15 |
| 1386149409 | Monique Imanii Brown | Behavioral Analyst | 511 Johnson Drive, Pleasanton, CA 94588 | 2018-03-29 |
| 1922509710 | Cierra Marie Barton | Behavioral Analyst | 5820 Stoneridge Mall Road, Suite 205, Pleasanton, CA 94588 | 2018-02-27 |
| 1851800056 | Delisa Simon | Nurse Practitioner | 4439 Stoneridge Dr Ste 110, Pleasanton, CA 94588 | 2017-09-20 |
| 1831611409 | One Health Hospice, Inc. | Hospice Care, Community Based | 7059 Commerce Cir, Suite G, Pleasanton, CA 94588 | 2017-07-14 |
| 1114478641 | Carlos Gavino | Behavior Technician | 5820 Stoneridge Mall Dr, Suite 205, Pleasanton, CA 94588 | 2016-10-19 |
| Find all providers in zip 94588 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780939447 | Alison Nicole Jones | Psychologist | 5700 Stoneridge Mall Rd Ste 315, Pleasanton, CA 94588 | 2012-07-18 |
| 1477837789 | Jeffrey P Phillips | Psychologist | 505 W 15th, Pleasanton, KS 66075-4095 | 2011-10-05 |
| 1073804308 | American College of Behavioral Medicine | Psychologist | 4637 Chabot Dr, Ste 102, Pleasanton, CA 94588-2805 | 2011-04-20 |
| 1780810655 | Christina Rosetti | Psychologist | 5776 Stoneridge Mall Rd Ste 340, Pleasanton, CA 94588-4514 | 2009-06-05 |
| 1528257904 | Jason Edward Neakrase | Psychologist | 60 Mission Dr Ste C, Pleasanton, CA 94566-7682 | 2007-10-22 |
| 1972728533 | David Mcmaster Echeandia | Psychologist | 4125 Mohr Ave Ste G, Pleasanton, CA 94566-4749 | 2007-04-17 |
| 1992822803 | Susannah Ruth Feder | Psychologist | 4713 1st St Ste 254, Pleasanton, CA 94566-7361 | 2007-03-24 |
| 1396891586 | Robert Eric Christensen | Psychologist | 3825 Hopyard Rd Ste 140, Kaiser Pleasanton Dep of Mental Health, Pleasanton, CA 94588-8530 | 2007-01-28 |
| 1568519403 | Kathleen M Herwatt | Psychologist | 4713 First Street, Suite 254, Pleasanton, CA 94566 | 2007-01-04 |
| 1811065733 | Richard Herbert Gelbard | Psychologist | 7601 Stoneridge Drive, Kaiser Permanente, Department of Psychiatry, Pleasanton, CA 94588-2899 | 2006-11-30 |
| Find all providers in PLEASANTON | ||||
| City | PLEASANTON |
| Zip Code | 94588 |
Please comment or provide details below to improve the information on DR. VIDA 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.