Individual provider Active NPI

Diana Wing-Yi Wong, AGACNP-BC, CCRN, CSC

  • Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1003750373
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95027538 Issued in CA
Practice address
1990 Fruitdale Ave
San Jose, CA 95128-2795
Phone
(408) 998-8447
NPI assigned
Apr 16, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95027538 CA Primary

Addresses

Primary practice location

1990 Fruitdale Ave
San Jose, CA 95128-2795

Mailing address

1675 Ebbetts Dr
Campbell, CA 95008-5111
Phone (909) 509-6011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260514004297 CA Practitioner - Nurse Practitioner 2567931983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quality Care Solution IncGroup PAC ID 3476969031, 12 clinicians

Practice addresses (Care Compare)

1601 Petersen Ave
San Jose, CA 95129-4844
Phone (832) 618-8479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95027538CAMDNurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1003750373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 EBBETTS DR",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950085111",
            "telephone_number": "909-509-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 FRUITDALE AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282795",
            "telephone_number": "408-998-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "DIANA",
        "middle_name": "WING-YI",
        "credential": "AGACNP-BC, CCRN, CSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-16",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95027538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.