Individual provider Active NPI

Annie Li-Wong, NP

  • Gerontology Nurse Practitioner
  • Burlingame, CA
National Provider Identifier
1629415765
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
22805 Issued in CA
Practice address
1828 El Camino Real
Suite 706
Burlingame, CA 94010-3103
Phone
(650) 777-9117
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 22805 CA Primary

Addresses

Primary practice location

1828 El Camino Real
Suite 706
Burlingame, CA 94010-3103

Mailing address

1828 El Camino Real
Suite 706
Burlingame, CA 94010-3103

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
22805CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1629415765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 EL CAMINO REAL",
            "address_2": "SUITE 706",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 EL CAMINO REAL",
            "address_2": "SUITE 706",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103103",
            "telephone_number": "650-777-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI-WONG",
        "first_name": "ANNIE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "22805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; 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.