Jung Wang, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP 17657 Issued in CA

Practice address

395 Oyster Point Blvd Ste 202
South San Francisco, CA 94080-1928

Phone

(650) 758-4700

NPI assigned

Sep 30, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Gus Wang Other name

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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1356778757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 CUESTA DR # 106B",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940403667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 OYSTER POINT BLVD STE 202",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940801928",
            "telephone_number": "650-758-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "JUNG",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 17657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GUS",
            "last_name": "WANG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Walgreens Pharmacy
• Wall Medical Group
• Wall Medical Inc (PMC Laboratory Services)
• Catherine Wall, PT
• Amy Wang
• Qingping Wang, M.D., PH.D.
• Judith Ann Ward, RN
• Ariel Washington
• Elizabeth M. Watson, MD
• Tarrah D Wauson, MFT

• Speech-Language Pathologist in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; 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.