Individual provider Active NPI

Audrey Wong

  • Behavior Analyst
  • Garden Grove, CA
National Provider Identifier
1609497312
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
12459 Lewis St Ste 201
Garden Grove, CA 92840-6606
Phone
(800) 249-1266
NPI assigned
May 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

12459 Lewis St Ste 201
Garden Grove, CA 92840-6606

Mailing address

2733 E 12TH St Ste C2
Brooklyn, NY 11235-4672
Phone (800) 249-1266

Other practice location 1

12387 Lewis St Ste 202
Garden Grove, CA 92840-4666
Phone (800) 249-1266

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": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1609497312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2733 E 12TH ST STE C2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354672",
            "telephone_number": "800-249-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12459 LEWIS ST STE 201",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928406606",
            "telephone_number": "800-249-1266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12387 Lewis St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928404666",
            "country_code": "US",
            "telephone_number": "800-249-1266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "AUDREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.