Justin Ching Lam Wong

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

89992 Issued in CA

Practice address

3280 E Foothill Blvd
Pasadena, CA 91107-3103

Phone

(626) 634-2203

NPI assigned

Jul 1, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Path to Growth Counseling Inc.

  • Mental Health Counselor
  • South Pasadena, CA
  • NPI 1528556651
  NPD (past) Authorized official

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1073824397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 FREMONT AVE FL 2",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910303224",
            "telephone_number": "626-634-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 E FOOTHILL BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073103",
            "telephone_number": "626-634-2203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5628 E Slauson Ave",
            "address_purpose": "LOCATION",
            "city": "Commerce",
            "state": "CA",
            "postal_code": "900402922",
            "country_code": "US",
            "telephone_number": "323-318-9960",
            "fax_number": "323-780-3211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "JUSTIN",
        "middle_name": "CHING LAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "89992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7667",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "95-2633765",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7184",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7368",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "7708",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremiah Wong
• Joann Wong, PHARMD.
• John W Wong, L.AC.
• Julie T.G. Wong, PSY.D.
• Justin Wong, D.O.
• Justina Wong
• Kristin Wong
• Larry Wong
• Lee Wong, CPO
• Li Wei Wong, BCBA

• Marriage & Family Therapist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.