Active NPI
Patricia Wong, NP
- Nurse Practitioner
- Fresno, CA
National Provider Identifier
1376614057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NPF6101
- Practice address
- 445 S Cedar Ave
Fresno, CA 93702-2907 - Phone
- (559) 459-5105
- NPI assigned
- Nov 13, 2006
- Last updated
- Jul 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NPF6101 | CA | Primary |
Addresses
Primary practice location
445 S Cedar Ave
Fresno, CA 93702-2907
Mailing address
4910 E Clinton Way
Suite 101
Fresno, CA 93727-1560
Phone (559) 453-5203
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN256271 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6101 | CA | MD | Occupational Therapist |
| NPF6101 | CA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Fresno Emergency Physicians Medical Group | Past | Accepting new patients | |
| Central California Faculty Medical Group, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Clovis, CA
- NPI 1992742852
-
- Emergency Medicine Physician
- Fresno, CA
- NPI 1639100118
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1376614057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4910 E CLINTON WAY",
"address_2": "SUITE 101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937271560",
"telephone_number": "559-453-5203",
"fax_number": "559-453-3311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 S CEDAR AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937022907",
"telephone_number": "559-459-5105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "PATRICIA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "NPF6101",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RN256271",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.