Active NPI
Alfred Wong
- Behavior Analyst
- San Bruno, CA
National Provider Identifier
1104487156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-23-65037
- Practice address
- 1001 Sneath LN Ste 200
San Bruno, CA 94066-2349 - Phone
- (650) 243-9849
- NPI assigned
- Jun 20, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-23-65037 | CA | Primary |
Addresses
Primary practice location
1001 Sneath LN Ste 200
San Bruno, CA 94066-2349
Mailing address
845 Crestview Dr
Millbrae, CA 94030-1508
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682380800000",
"number": "1104487156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "845 CRESTVIEW DR",
"city": "MILLBRAE",
"state": "CA",
"postal_code": "940301508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 SNEATH LN STE 200",
"city": "SAN BRUNO",
"state": "CA",
"postal_code": "940662349",
"telephone_number": "650-243-9849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "ALFRED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-20",
"last_updated": "2023-04-25",
"certification_date": "2023-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-23-65037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bruno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.