Active NPI
Yun Wang, PSYD
- Clinical Psychologist
- Cambridge, MA
National Provider Identifier
1629432877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10331
- Practice address
- 65 Walden St
Cambridge, MA 02140-3325 - Phone
- (617) 297-7791
- NPI assigned
- Apr 13, 2016
- Last updated
- Nov 13, 2022
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 10331 | MA | Primary |
Addresses
Primary practice location
65 Walden St
Cambridge, MA 02140-3325
Mailing address
165 Middlesex Ave # 1089
Somerville, MA 02145-1105
Phone (617) 297-7791
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 |
|---|---|---|---|
| Synrise Wellness LLC | Current | Accepting new patients |
Locations
165 Middlesex Ave
Somerville, MA 02145
Phone (508) 202-0387
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Cambridge, MA
- NPI 1316667207
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668297600000",
"number": "1629432877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 MIDDLESEX AVE # 1089",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021451105",
"telephone_number": "617-297-7791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 WALDEN ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021403325",
"telephone_number": "617-297-7791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "YUN",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-13",
"last_updated": "2022-11-13",
"certification_date": "2022-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "10331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.