Individual provider Active NPI

Catherine Wong, RN-NP

  • Nurse Practitioner
  • Hacienda Heights, CA
National Provider Identifier
1174656789
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP11905 Issued in CA
Practice address
17134 Colima Rd Ste E
Hacienda Heights, CA 91745-6737
Phone
(626) 820-0603
Fax
(626) 820-0602
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN507738 CA
Nurse Practitioner 363L00000X NP11905 CA Primary

Addresses

Primary practice location

17134 Colima Rd Ste E
Hacienda Heights, CA 91745-6737

Mailing address

17134 Colima Rd Ste E
Hacienda Heights, CA 91745-6737
Phone (626) 820-0603

Other identifiers 1

IdentifierTypeStateIssuer
RN507738MedicaidCA

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041227000436 CA Practitioner - Nurse Practitioner 8325006190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniel C Choo MD Cardiovascular Medical CorporationGroup PAC ID 9032196159, 2 clinicians

Practice addresses (Care Compare)

17134 Colima Rd
Suite E
Hacienda Heights, CA 91745-6737
Phone (626) 820-0603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN507738CAMDRegistered Nurse
NP11905CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel C. Choo, M.D., Cardiovascular Medical Corporation CurrentSince Sep 3, 2013 Accepting new patients

Locations

101 E Valencia Mesa Dr
Fullerton, CA 92835
Phone (714) 446-7505

17134 Colima Rd
Ste E
Hacienda Hts, CA 91745
Phone (626) 387-0196

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1174656789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17134 COLIMA RD STE E",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456737",
            "telephone_number": "626-820-0603",
            "fax_number": "626-820-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17134 COLIMA RD STE E",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456737",
            "telephone_number": "626-820-0603",
            "fax_number": "626-820-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "CATHERINE",
        "credential": "RN-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN507738",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP11905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN507738",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hacienda Heights, CA

Sources for this page

Verify at the official NPI Registry.