DR. KENNETH MARK WOOG (NPI# 1437223245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437223245 |
| Entity Type | Individual |
| Full Name | DR. KENNETH MARK WOOG |
| Credential | PSY.D. |
| Practice Address |
23591 El Toro Rd Suite 104 Lake Forest CA 92630-4774 |
| Mailing Address |
22365 El Toro Rd Pmb 271 Lake Forest CA 92630-5053 |
| Practice Telephone | 9494224120 |
| Practice Fax Number | 9492960398 |
| Mailing Telephone | 9494224120 |
| Mailing Fax Number | 9492960398 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2010-05-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PSY20560 | CA | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PSY20560 | CA | Behavioral Health & Social Service Providers |
| N | 103TF0000X |
Psychologist Specialization: Family |
PSY20560 | CA | Behavioral Health & Social Service Providers |
| Street Address |
23591 EL TORO RD SUITE 104 |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630-4774 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174566327 | Marilynn Murphy Evans | Psychologist | 23591 El Toro Rd, Suite 204, Lake Forest, CA 92630-4774 | 2006-06-14 |
| 1699217935 | Careline Homecare Services, Inc. | In Home Supportive Care | 23591 El Toro Rd, Suite 265, Lake Forest, CA 92630-4774 | 2016-11-16 |
| 1063881951 | Western Horizon Hospice and Palliative Care, Inc. | Hospice Care, Community Based | 23591 El Toro Rd, Suite 200, Lake Forest, CA 92630-4774 | 2015-09-21 |
| 1396019824 | Heather N Borsuk | Lactation Consultant, Non-RN | 23591 El Toro Rd, Ste 176, Lake Forest, CA 92630-4774 | 2012-03-01 |
| 1649597196 | Straight Enterprises, Inc. | Home Health | 23591 El Toro Rd, Suite 155, Lake Forest, CA 92630-4774 | 2010-04-23 |
| 1558684506 | Amani Soliman D.d.s,inc | Dentist | 23591 El Toro Rd, Suite #130, Lake Forest, CA 92630-4774 | 2010-03-04 |
| 1265637342 | Amani Soliman | Dentist | 23591 El Toro Rd, Suite # 130, Lake Forest, CA 92630-4774 | 2007-06-18 |
| 1265649610 | Janet L Hanna | Marriage & Family Therapist | 23591 El Toro Rd, Ste. 275, Lake Forest, CA 92630-4774 | 2007-05-16 |
| 1962523738 | Gayle Bondy | Counselor | 23591 El Toro Rd, Ste 106, Lake Forest, CA 92630-4774 | 2007-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194370338 | Ashlee Nicole-morton Sourapas | Midwife | 22672 Lambert Street, Suite 611, Lake Forest, CA 92630 | 2019-08-05 |
| 1134784879 | Scott Mach Enterprises | Custodial Care Facility | 23235 Cavanaugh Road, Lake Forest, CA 92630 | 2019-05-08 |
| 1992368930 | James Daniel Ticorat | Pharmacist | 25051 Calle Arenal, Lake Forest, CA 92630 | 2019-04-16 |
| 1770058349 | Tara L Anderson | Physician Assistant | 22365 El Toro Rd Unit 310, Lake Forest, CA 92630 | 2018-10-10 |
| 1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
| 1326520867 | Katherine Marie Billings | Speech-Language Pathologist | 25454 Navajo, Lake Forest, CA 92630 | 2018-08-31 |
| 1205339611 | Orange County Physiotherapy Services, P.C. | Physical Therapist | 22821 Aspan St., #100, Lake Forest, CA 92630 | 2018-03-12 |
| 1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
| 1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
| 1275072589 | Anhtu Wu | Pharmacist | 23182 Vista Way, Lake Forest, CA 92630 | 2017-02-20 |
| Find all providers in zip 92630 | ||||
| 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 | LAKE FOREST |
| Zip Code | 92630 |
Please comment or provide details below to improve the information on DR. KENNETH MARK WOOG.
| 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.