Jade Wong, OTR/L, CHT, CLT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

14398 Issued in CA

Practice address

2703 Rockefeller LN Apt 2
Redondo Beach, CA 90278-4299

Phone

(808) 285-5090

NPI assigned

Aug 13, 2018

Last updated

May 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Reach Beyond Therapy IncGroup PAC ID 4082156864, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Reach Beyond Therapy Inc

  • Occupational Therapist
  • Redondo Beach, CA
  • NPI 1447099007
  Medicare reassignment Care Compare group NPD Authorized official
• Physical Therapy Care, Inc

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1033299029
  NPD (past)
• Select CS Physical Therapy, P.C.

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Ridgecrest, CA
  • NPI 1386228302
  NPD (past)

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1255810008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 ROCKEFELLER LN APT 2",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784299",
            "telephone_number": "808-285-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 ROCKEFELLER LN APT 2",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902784299",
            "telephone_number": "808-285-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JADE",
        "credential": "OTR/L, CHT, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "14398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mara Joanna Wolfsen, LCSW
• Fredrick Nathaniel Wolk, M.D.
• Kelly Wolschon, RDN
• Julie M Woltil, PHD
• Heather Michelle Wondra, MFTI
• James Christopher Wong, RD
• Lewis Wong, M.D.
• Shirley G Wong, R.D
• Kyle Masamichi Woo
• Casey Wood, DC

• Physical Medicine & Rehabilitation Physician in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.