Active NPI
Fiona Wong, OTR/L
- Occupational Therapist
- Berkeley, CA
National Provider Identifier
1073948964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11204
- Practice address
- 2198 6TH St
Suite 100
Berkeley, CA 94710-2233 - Phone
- (510) 367-0712
- NPI assigned
- Sep 10, 2013
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 11204 | CA | Primary |
Addresses
Primary practice location
2198 6TH St
Suite 100
Berkeley, CA 94710-2233
Mailing address
530 Madison St
Albany, CA 94706-1117
Phone (510) 367-0712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11204 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399248000000",
"number": "1073948964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 MADISON ST",
"city": "ALBANY",
"state": "CA",
"postal_code": "947061117",
"telephone_number": "510-367-0712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2198 6TH ST",
"address_2": "SUITE 100",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947102233",
"telephone_number": "510-367-0712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "FIONA",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-10",
"last_updated": "2014-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "11204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.