Individual provider Active NPI

Kirra Wong

  • Marriage & Family Therapist
  • Gilbert, AZ
National Provider Identifier
1366790339
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
865 E Baseline Rd Ste 1003
Gilbert, AZ 85233-1246
Phone
(480) 818-9655
NPI assigned
Aug 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

865 E Baseline Rd Ste 1003
Gilbert, AZ 85233-1246

Mailing address

865 E Baseline Rd Ste 1003
Gilbert, AZ 85233-1246
Phone (480) 818-9655

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1345766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1366790339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 E BASELINE RD STE 1003",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852331246",
            "telephone_number": "480-818-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 E BASELINE RD STE 1003",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852331246",
            "telephone_number": "480-818-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KIRRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-24",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.