Individual provider Active NPI

Wing Man Winnie So

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1407332299
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
132154 Issued in CA
Practice address
1520 Stockton St
San Francisco, CA 94133-3354
Phone
(415) 391-9686
NPI assigned
Jul 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 115113 CA
Student in an Organized Health Care Education/Training Program 390200000X
Marriage & Family Therapist 106H00000X 132154 CA Primary

Addresses

Primary practice location

1520 Stockton St
San Francisco, CA 94133-3354

Mailing address

1520 Stockton St
San Francisco, CA 94133-3354
Phone (415) 391-9686

Other practice location 1

3626 Balboa St
San Francisco, CA 94121-2604
Phone (415) 668-5955

Other practice location 2

1038 Post St
San Francisco, CA 94109-5603
Phone (415) 775-2636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116001661 CA Practitioner - Marriage and Family Therapist 3476940248 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
132154CAMDClinical Social Worker
115113CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
North East Medical Services CurrentSince Jan 1, 2024 Accepting new patients
North East Medical Services CurrentSince Jan 1, 2024 Accepting new patients
North East Medical Services Current Accepting new patients

Locations

1850 Sullivan Ave
Ste 150
Daly City, CA 94015
Phone (650) 991-5880

211 Eastmoor Ave
Daly City, CA 94015
Phone (650) 550-3923

1400 Noriega St
San Francisco, CA 94122
Phone (415) 352-5093

1520 Stockton St
San Francisco, CA 94133

1450 Noriega St
San Francisco, CA 94122

3431 Taraval St
San Francisco, CA 94116

82 Leland Ave
San Francisco, CA 94134
Phone (415) 391-9688

2574 San Bruno Ave
San Francisco, CA 94134
Phone (415) 352-5090

1033 Clement St
San Francisco, CA 94118
Phone 4153919686 ext. 5572

1870 Lundy Ave
San Jose, CA 95131
Phone (408) 573-9686

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1531526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1407332299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 STOCKTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333354",
            "telephone_number": "415-391-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 STOCKTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333354",
            "telephone_number": "415-391-9686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3626 Balboa St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941212604",
            "country_code": "US",
            "telephone_number": "415-668-5955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1038 Post St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941095603",
            "country_code": "US",
            "telephone_number": "415-775-2636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SO",
        "first_name": "WING MAN WINNIE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-14",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "115113",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "132154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.