Active NPI
Minjun Wang
- Professional Counselor
- San Mateo, CA
National Provider Identifier
1023461720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2970
- Practice address
- 1777 Borel PL Ste 400
San Mateo, CA 94402-3513 - Phone
- (415) 429-6130
- Fax
- (855) 229-3626
- NPI assigned
- Jul 18, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2970 | CA | Primary |
Addresses
Primary practice location
1777 Borel PL Ste 400
San Mateo, CA 94402-3513
Mailing address
1815 Ogden Dr Apt 5
Burlingame, CA 94010-5302
Phone (415) 429-6130
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250508002625 | CA | Practitioner - Mental Health Counselor | 9335665546 | Practice locations: San Mateo, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Liberty Through Therapy Professional Clinical Counselor, PC | Professional | Current | Accepting new patients |
Locations
1777 Borel Pl
Ste 400
San Mateo, CA 94402
Phone (650) 212-5642
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.
-
- Professional Counselor
- San Mateo, CA
- NPI 1043144298
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766102400000",
"number": "1023461720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1815 OGDEN DR APT 5",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940105302",
"telephone_number": "415-429-6130",
"fax_number": "855-229-3626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1777 BOREL PL STE 400",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944023513",
"telephone_number": "415-429-6130",
"fax_number": "855-229-3626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "MINJUN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-18",
"last_updated": "2025-12-19",
"certification_date": "2025-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "2970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.