Mimi Wong, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY25379 Issued in CA

Practice address

870 Market St
Suite 744
San Francisco, CA 94102-3099

Phone

(415) 857-1157

NPI assigned

Nov 20, 2006

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Alameda Health System

  • Surgery Physician
  • Oakland, CA
  • NPI 1740332931
  Medicare reassignment NPD
• City & County of San Francisco

  • Clinical Medical Laboratory
  • San Francisco, CA
  • NPI 1982737524
  Medicare reassignment NPD
• University of California SFGH Medical Group

  • Psychiatry Physician
  • San Francisco, CA
  • NPI 1356316418
  Medicare reassignment NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Newark, CA
  • NPI 1497956288
  NPD
• City & County of San Francisco

  • Community Health/Public Health Clinical Nurse Specialist
  • San Francisco, CA
  • NPI 1609041060
  NPD
• City and County of San Francisco

  • Methadone Clinic
  • San Francisco, CA
  • NPI 1578787925
  NPD
• University of California SFGH Medical Group

  • Vascular Surgery Physician
  • San Francisco, CA
  • NPI 1033913959
  NPD
• Siyan Clinical Corporation

  • Psychiatry Physician
  • Santa Rosa, CA
  • NPI 1568732972
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1285708024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5330",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940835330",
            "telephone_number": "415-857-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 MARKET ST",
            "address_2": "SUITE 744",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941023099",
            "telephone_number": "415-857-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "MIMI",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CA",
            "license": "PSY25379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Keyne Wong
• Michael S Wong, D.C.
• Michele Julie Wong
• Michelle Wong
• Michelle Man Ching Wong
• Ming Cheung Alfred Wong, RPH
• Moson Wong
• Nancy Wong, MFT
• Nancy Sze Wan Wong, RN, FNP
• Nancy Yih Wong, MS, RD

• Clinical Neuropsychologist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Clinical Neuropsychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.