Individual provider Active NPI

Lynette Wong, M.S.

  • Speech-Language Pathologist
  • Oakland, CA
National Provider Identifier
1720286818
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP5700 Issued in CA
Practice address
312 Clay St Ste 150
Oakland, CA 94607-3510
Phone
(510) 428-8403
Fax
(510) 238-9764
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X SLP5700 CA
Rehabilitation Practitioner 225400000X
Speech-Language Pathologist 235Z00000X SP5700 CA Primary

Addresses

Primary practice location

312 Clay St Ste 150
Oakland, CA 94607-3510

Mailing address

747 52ND St
Oakland, CA 94609-1809
Phone (510) 428-8403

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Lynette.Wong@ucsf.edu

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)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SLP5700CAMDCounselor
SP5700CAMDSpeech-Language Pathologist

Interoperability endpoints

  • Direct secure messaging: lynette.wong@ucsf.edu

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1720286818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-8403",
            "fax_number": "510-238-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 CLAY ST STE 150",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946073510",
            "telephone_number": "510-428-8403",
            "fax_number": "510-238-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "LYNETTE",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "SLP5700",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP5700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lynette.Wong@ucsf.edu",
            "affiliation": "N",
            "address_1": "312 Clay St Ste 150",
            "city": "Oakland",
            "state": "CA",
            "country_code": "US",
            "postal_code": "946073510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.