Jorge Wong, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY21180 Issued in CA

Practice address

2400 Moorpark Ave
Suite 300
San Jose, CA 95128-2631

Phone

(408) 975-2730

Fax

(408) 975-2745

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Alameda County

  • Community/Behavioral Health Agency
  • Hayward, CA
  • NPI 1780716381
  Medicare reassignment NPD
• Alameda County

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1417089822
  NPD
• County of Alameda

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1881632867
  NPD
• Richmond Area Multi-Services, Inc.

  • Community/Behavioral Health Agency
  • San Francisco, CA
  • NPI 1548312309
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1689735284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 RACE ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263130",
            "telephone_number": "408-961-9818",
            "fax_number": "408-961-9856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE",
            "address_2": "SUITE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282631",
            "telephone_number": "408-975-2730",
            "fax_number": "408-975-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CINICAL PSYCHOLOGY LICENS",
            "identifier": "PSY21180",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HousingServices@healthtrust.org",
            "affiliation": "N",
            "endpointDescription": "Department only secured email endpoint.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2400 Moorpark Ave",
            "address_2": "Suite 300",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951282631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Irene Shuk Wong, N.P.
• Jane Ruby Wong
• Jane Y Wong, LPT
• Jeffrey Wong, DC
• John W Wong
• Kaklam Wong, RNNP
• Kam Wong, RPH
• Karen Anita Wong, SLP
• Kate Wong
• Kenneth Wong, MD

• Clinical Psychologist in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.