Active NPI
Stacie Anne Wong, PT, DPT
- Physical Therapist
- Danville, CA
National Provider Identifier
1225588114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT291725
- Practice address
- 120 Benjamin LN
Danville, CA 94506-4777 - Phone
- (925) 389-8150
- NPI assigned
- Oct 4, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT291725 | CA | Primary |
Addresses
Primary practice location
120 Benjamin LN
Danville, CA 94506-4777
Mailing address
120 Benjamin LN
Danville, CA 94506-4777
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 |
|---|---|---|---|
| PT291725 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475539200000",
"number": "1225588114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 BENJAMIN LN",
"city": "DANVILLE",
"state": "CA",
"postal_code": "945064777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 BENJAMIN LN",
"city": "DANVILLE",
"state": "CA",
"postal_code": "945064777",
"telephone_number": "925-389-8150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "STACIE",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-04",
"last_updated": "2016-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT291725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.