Individual provider Active NPI

Tracy Mingli Ong, PH.D., BCBA-D

  • Intellectual & Developmental Disabilities Psychologist
  • Oakland, CA
National Provider Identifier
1629200712
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Practice address
445 Bellevue Ave Ste 201B
Oakland, CA 94610-4923
Phone
(866) 381-1668
Fax
(866) 381-1668
NPI assigned
Aug 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Cognitive & Behavioral Psychologist 103TB0200X
Counseling Psychologist 103TC1900X PSY24777 CA
Intellectual & Developmental Disabilities Psychologist 103TM1800X Primary

Addresses

Primary practice location

445 Bellevue Ave Ste 201B
Oakland, CA 94610-4923

Mailing address

1781 Helane CT
Benicia, CA 94510-2659
Phone (866) 381-1668

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY24777CAMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1250899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1629200712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1781 HELANE CT",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945102659",
            "telephone_number": "866-381-1668",
            "fax_number": "866-381-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 BELLEVUE AVE STE 201B",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104923",
            "telephone_number": "866-381-1668",
            "fax_number": "866-381-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONG",
        "first_name": "TRACY",
        "middle_name": "MINGLI",
        "credential": "PH.D., BCBA-D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-22",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY24777",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.