Su Wong, M.S., BCBA

Individual provider Active NPI Behavior Analyst · Pasadena, CA

NPI 1679948574 · NPPES record last updated Dec 4, 2015

Key facts

NPI
1679948574
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1-14-16391 (CA)
Practice address
465 E Union St Ste 105
Pasadena, CA 91101-1783
Phone
(626) 927-6341
NPI assigned
Dec 4, 2015
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Behavioral & Educational Services, LLC Behavior Analyst Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-14-16391 CA Yes

Addresses

Primary practice location

465 E Union St Ste 105
Pasadena, CA 91101-1783

Mailing address

465 E Union St Ste 105
Pasadena, CA 91101-1783

Other providers in Pasadena, CA

All providers in Pasadena, CA · Behavior Analyst in California

Sources for this page

Verify at the official NPI Registry.