Active NPI
Stacy Lynn Wong, DPT
- Sports Physical Therapist
- Walnut Creek, CA
National Provider Identifier
1447428412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 33995
- Practice address
- 2405 Shadelands Dr
Walnut Creek, CA 94598-2444 - Phone
- (925) 939-8585
- Fax
- (925) 933-2709
- NPI assigned
- Feb 13, 2008
- 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 |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 33995 | CA | Primary |
Addresses
Primary practice location
2405 Shadelands Dr
Walnut Creek, CA 94598-2444
Mailing address
PO Box 31396
Walnut Creek, CA 94598-8396
Phone (925) 939-8585
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Golden State Orthopedics & Spine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- San Francisco, CA
- NPI 1457004897
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393804800000",
"number": "1447428412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31396",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945988396",
"telephone_number": "925-939-8585",
"fax_number": "925-933-2709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2405 SHADELANDS DR",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982444",
"telephone_number": "925-939-8585",
"fax_number": "925-933-2709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "STACY",
"middle_name": "LYNN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-13",
"last_updated": "2014-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "CA",
"license": "33995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.