Active NPI
Jason Soong-Jee Wong
- Clinical Psychologist
- Isla Vista, CA
National Provider Identifier
1194363598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 32402
- Practice address
- 948 Embarcadero del Norte Ste 102
Isla Vista, CA 93117-5106 - Phone
- (805) 699-6668
- NPI assigned
- Dec 16, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 32402 | CA | Primary |
Addresses
Primary practice location
948 Embarcadero del Norte Ste 102
Isla Vista, CA 93117-5106
Mailing address
948 Embarcadero del Norte Ste 102
Isla Vista, CA 93117-5106
Phone (805) 699-6668
Other practice location 1
Ucsb Counseling and Psychological Services Building 599
Santa Barbara, CA 93106-0001
Phone (805) 893-4411
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 |
|---|---|---|---|
| 32402 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614124800000",
"number": "1194363598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "948 EMBARCADERO DEL NORTE STE 102",
"city": "ISLA VISTA",
"state": "CA",
"postal_code": "931175106",
"telephone_number": "805-699-6668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "948 EMBARCADERO DEL NORTE STE 102",
"city": "ISLA VISTA",
"state": "CA",
"postal_code": "931175106",
"telephone_number": "805-699-6668"
}
],
"practiceLocations": [
{
"address_1": "Ucsb Counseling and Psychological Services Building 599",
"address_purpose": "LOCATION",
"city": "Santa Barbara",
"state": "CA",
"postal_code": "931060001",
"country_code": "US",
"telephone_number": "805-893-4411",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WONG",
"first_name": "JASON SOONG-JEE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-16",
"last_updated": "2021-02-24",
"certification_date": "2021-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "32402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Isla Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.