Stephanie Wong, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60180 Issued in CA

Practice address

19742 Macarthur Blvd
Irvine, CA 92612-2432

Phone

(949) 428-0330

NPI assigned

Oct 23, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1634947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634947200000",
    "number": "1346904604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 WILD ROSE PL",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926567058",
            "telephone_number": "949-648-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19742 MACARTHUR BLVD",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122432",
            "telephone_number": "949-428-0330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Thalia St",
            "address_purpose": "LOCATION",
            "city": "Laguna Beach",
            "state": "CA",
            "postal_code": "926512713",
            "country_code": "US",
            "telephone_number": "949-499-0577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-23",
        "last_updated": "2021-10-23",
        "certification_date": "2021-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA60180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Wong
• Nelly Wong
• Rochelle Erin Wong, MD
• Rotsarin Wong, RN, IBCLC
• Ryan Enoch Wong, PT, DPT
• Tiara L Wong
• Tristyn Wong
• Victoria Marie Wong
• Wesley K Wong, D.D.S.
• Will M Wong, D.D.S.

• Physician Assistant in Irvine, CA
• Providers in Irvine, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.

Verify at the official NPI Registry.