Wai Yan Ip Ngan, MFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MFC41365 Issued in CA

Practice address

17181 Gale Ave Ste C
City of Industry, CA 91745-1817

Phone

(909) 301-8801

NPI assigned

Nov 19, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Agnes Ip Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622332800000",
    "number": "1649514357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 N LEMON AVE # 225",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917892344",
            "telephone_number": "909-301-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17181 GALE AVE STE C",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917451817",
            "telephone_number": "909-301-8801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "382 N Lemon Ave # 225",
            "address_purpose": "LOCATION",
            "city": "Walnut",
            "state": "CA",
            "postal_code": "917892344",
            "country_code": "US",
            "telephone_number": "909-802-6662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IP NGAN",
        "first_name": "WAI",
        "middle_name": "YAN",
        "name_prefix": "Dr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2021-05-30",
        "certification_date": "2021-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFC41365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGNES",
            "last_name": "IP",
            "prefix": "DR.",
            "credential": "MFT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Reana Jackson
• James Song MD, a Professional Corporation (James Song MD, Inc)
• Emma Jarnyneh

• Mental Health Counselor in City of Industry, CA
• Providers in City of Industry, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2021; 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.