Individual provider Active NPI

Sum-Yee Wang, MFT

  • Marriage & Family Therapist
  • Santa Monica, CA
National Provider Identifier
1053598243
Registry record updated Oct 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC45049 Issued in CA
Practice address
2825 Santa Monica Blvd Ste 300a
Santa Monica, CA 90404-2429
Phone
(310) 943-9008
NPI assigned
Jan 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC45049 CA Primary

Addresses

Primary practice location

2825 Santa Monica Blvd Ste 300a
Santa Monica, CA 90404-2429

Mailing address

2825 Santa Monica Blvd Ste 300a
Santa Monica, CA 90404-2429
Phone (310) 795-1184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 25, 2024 through Jan 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC45049CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540598400000",
    "number": "1053598243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 SANTA MONICA BLVD STE 300A",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042429",
            "telephone_number": "310-795-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 SANTA MONICA BLVD STE 300A",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042429",
            "telephone_number": "310-943-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SUM-YEE",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-30",
        "last_updated": "2018-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC45049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.