Individual provider Active NPI

Ryan Truman Wong, PHD, LP

  • Psychologist
  • Pasadena, CA
National Provider Identifier
1457068892
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35309 Issued in CA
Practice address
675 S Arroyo Pkwy Ste 420
Pasadena, CA 91105-3215
Phone
(925) 282-1778
NPI assigned
Nov 4, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X PSB94027197 CA
Clinical Psychologist 103TC0700X PSY35309 CA
Psychologist 103T00000X 35309 CA Primary

Addresses

Primary practice location

675 S Arroyo Pkwy Ste 420
Pasadena, CA 91105-3215

Mailing address

675 S Arroyo Pkwy Ste 420
Pasadena, CA 91105-3215
Phone (925) 282-1778

Other practice location 1

11980 Mount Vernon Ave
Grand Terrace, CA 92313-5172
Phone (909) 864-1097

Other identifiers 1

IdentifierTypeStateIssuer
PSY35309OtherCABOARD OF PSYCHOLOGY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241022000116 TX Practitioner - Clinical Psychologist 2668904160 Reassigns benefits to 1 organization
I20250909002202 CA Practitioner - Clinical Psychologist 2668904160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

675 S Arroyo Pkwy
Suite 420
Pasadena, CA 91105-3215
Phone (925) 282-1778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35309CAMDPsychologist
PSB94027197CAMDPsychologist
PSY35309CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside-San Bernardino County Indian Health, Inc Multi-Specialty CurrentSince Sep 4, 2024 Accepting new patients
Pacific Coast Psychiatric Associates Inc Clinical CurrentSince Sep 1, 2025 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc Multi-Specialty CurrentSince Sep 4, 2024 Accepting new patients
Riverside-San Bernardino County Indian Health, Inc. Multi-Specialty Current Accepting new patients

Locations

11980 Mount Vernon Ave
Grand Terrace, CA 92313
Phone (909) 783-8470

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 403-0474

675 S Arroyo Pkwy
Ste 420
Pasadena, CA 91105
Phone (626) 795-0617

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

23119 Soboba Rd
San Jacinto, CA 92583
Phone (951) 654-0803

Organizations & group practices 4

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": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1457068892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 S ARROYO PKWY STE 420",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053215",
            "telephone_number": "925-282-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 S ARROYO PKWY STE 420",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053215",
            "telephone_number": "925-282-1778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11980 Mount Vernon Ave",
            "address_purpose": "LOCATION",
            "city": "Grand Terrace",
            "state": "CA",
            "postal_code": "923135172",
            "country_code": "US",
            "telephone_number": "909-864-1097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "RYAN",
        "middle_name": "TRUMAN",
        "credential": "PHD, LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-04",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB94027197",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY35309",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "35309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PSYCHOLOGY",
            "identifier": "PSY35309",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.