Individual provider Active NPI

Jihyun Wong

  • Nurse Practitioner
  • Fontana, CA
National Provider Identifier
1366351876
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95039964 Issued in CA
Practice address
16685 Sierra Lakes Pkwy # 100
Fontana, CA 92336-1255
Phone
(909) 347-0009
NPI assigned
Sep 2, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95039964 CA Primary

Addresses

Primary practice location

16685 Sierra Lakes Pkwy # 100
Fontana, CA 92336-1255

Mailing address

16685 Sierra Lakes Pkwy # 100
Fontana, CA 92336-1255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1366351876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16685 SIERRA LAKES PKWY # 100",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16685 SIERRA LAKES PKWY # 100",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361255",
            "telephone_number": "909-347-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JIHYUN",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95039964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.