TRACY YICK WONG (NPI# 1245554831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245554831 |
| Entity Type | Individual |
| Full Name | TRACY YICK WONG |
| Credential | RDH |
| Practice Address |
411 4th St San Rafael CA 94901-5716 |
| Practice Telephone | 4154735450 |
| Practice Fax Number | 4154735460 |
| Mailing Telephone | 4154735450 |
| Mailing Fax Number | 4154735460 |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2010-03-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 11713 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821177239 | Tracy Wong | Optometrist | 2101 Rosecrans Ave, El Segundo, CA 90245-4749 | 2006-11-04 |
| 1750922647 | Tracy Elissa Lew Wong | Social Worker | 2308 J St Ste D, Sacramento, CA 95816-4718 | 2019-10-02 |
| 1841727179 | Tracy May Wong | Pharmacist | 1843 S La Cienega Blvd, Los Angeles, CA 90035-4603 | 2017-05-17 |
| 1851689814 | Tracy A Wong | Social Worker | 1 Boston Medical Ctr Pl, Boston, MA 02118-2908 | 2011-07-12 |
| 1528237963 | Tracy Wong | Speech-Language Pathologist | 423 Locust St, San Francisco, CA 94118-1844 | 2008-02-28 |
| 1083703268 | Tracy Wong | Pharmacist | 1200 El Camino Real, Medical Office Building, 4th Floor, Room 4-9965, South San Francisco, CA 94080-3208 | 2006-10-12 |
| Street Address |
411 4TH ST |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-5716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396165981 | Martha De La Pena | Dentist | 411 4th St, San Rafael, CA 94901-5716 | 2014-04-22 |
| 1669898318 | Aarin Crawford | Dental Hygienist | 411 4th St, San Rafael, CA 94901-5716 | 2014-03-05 |
| 1013272079 | Ann P. Adams | Dental Hygienist | 411 4th St, San Rafael, CA 94901-5716 | 2012-07-05 |
| 1144514498 | Tina Goldiano | Dental Hygienist | 411 4th St, San Rafael, CA 94901-5716 | 2011-06-03 |
| 1770807208 | Maria Maldonado | Dental Assistant | 411 4th St, San Rafael, CA 94901-5716 | 2010-03-26 |
| 1124342654 | Sally Landis | Dental Assistant | 411 4th St, San Rafael, CA 94901-5716 | 2010-03-26 |
| 1992029722 | Michael P. Aaronson | Dentist | 411 4th St, San Rafael, CA 94901-5716 | 2010-03-23 |
| 1932423001 | Denny Phan | Dental Assistant | 411 4th St, San Rafael, CA 94901-5716 | 2010-03-18 |
| 1932423027 | Maria Hernandez | Dental Assistant | 411 4th St, San Rafael, CA 94901-5716 | 2010-03-18 |
| 1457675530 | Carlos Cam | Dental Assistant | 411 4th St, San Rafael, CA 94901-5716 | 2010-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457986762 | Erick Estrada | Dental Hygienist | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2020-03-06 |
| 1003454489 | Emmeline Lui | Dental Hygienist | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2019-12-16 |
| 1669898318 | Aarin Crawford | Dental Hygienist | 411 4th St, San Rafael, CA 94901-5716 | 2014-03-05 |
| 1013272079 | Ann P. Adams | Dental Hygienist | 411 4th St, San Rafael, CA 94901-5716 | 2012-07-05 |
| 1144514498 | Tina Goldiano | Dental Hygienist | 411 4th St, San Rafael, CA 94901-5716 | 2011-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841046 | Betty Satomi Fukumoto | Dental Hygienist | 16008 S Manhattan Pl, Gardena, CA 90247-3681 | 2020-11-08 |
| 1417558180 | Maria Antonette De Lara Kim | Dental Hygienist | 66 S San Gorgonio Ave Ste 5, Banning, CA 92220-6020 | 2020-11-07 |
| 1083215982 | Sokbunntha Yan | Dental Hygienist | 5810 Fidler Ave, Lakewood, CA 90712-1251 | 2020-11-06 |
| 1649871914 | Maryam Ghahramani Shahneshin | Dental Hygienist | 1961 Grove Pl, Escondido, CA 92027-4101 | 2020-11-04 |
| 1285234047 | Maryann Detar | Dental Hygienist | 3154 Alum Rock Ave, San Jose, CA 95127-2903 | 2020-10-29 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1336748896 | Cynthia Garcia Macdougall | Dental Hygienist | 444 Hermosa Ave Apt 302, Hermosa Beach, CA 90254-4433 | 2020-10-25 |
| 1346849163 | Ambrosia Evon Steljes | Dental Hygienist | Building 13128 14th Street, Camp Pendleton, CA 92055-5221 | 2020-10-22 |
| 1427657261 | Julie Lynn March | Dental Hygienist | 19871 Mitscher Way Bldg 2495, San Diego, CA 92145-5103 | 2020-10-22 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
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| 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.