Irene Shuk Wong, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

12816 Issued in CA

Practice address

4855 Atherton Ave
San Jose, CA 95130

Phone

(888) 357-3058

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

Other names 1

• Miss Shuk L Wong Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• County of San Mateo

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  Medicare reassignment NPD
• County of San Mateo

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• Bay Area Rehab & Medical

  • Physical Medicine & Rehabilitation Physician
  • Fremont, CA
  • NPI 1518686765

  Nurse Practitioner

  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": "1567123200000",
    "number": "1366516205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR STE 150",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "562-622-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 ATHERTON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95130",
            "telephone_number": "888-357-3058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "795 Willow Rd,",
            "address_2": "331C",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "94025",
            "country_code": "US",
            "telephone_number": "650-493-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "IRENE",
        "middle_name": "SHUK",
        "name_prefix": "Miss",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "12816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHUK",
            "last_name": "WONG",
            "middle_name": "L",
            "prefix": "MISS",
            "credential": "N.P.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Francis Dominic Wong, D.O
• Geary Wong, RPH
• Grace Kinling Wong, O.D.
• Han Kwan Wong, PHARM.D.
• Harland Wong, OPAC
• Jane Ruby Wong
• Jane Y Wong, LPT
• Jeffrey Wong, DC
• John W Wong
• Jorge Wong, PHD

• Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.