Individual provider Active NPI

Vincent Wing Ching Fong, LMFT

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1740840396
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT125206 Issued in CA
Practice address
1801 Vicente St
San Francisco, CA 94116-2923
Phone
(415) 681-3211
NPI assigned
Jun 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT125206 CA Primary
Marriage & Family Therapist 106H00000X AMFT97966 CA
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

1801 Vicente St
San Francisco, CA 94116-2923

Mailing address

3145 Geary Blvd. #423
San Francisco, CA 94118
Phone (415) 295-6573

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

State licenses

LicenseStateTypeSpecialty
AMFT97966CAMDMarriage & Family Therapist
LMFT125206CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1740840396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 GEARY BLVD. #423",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94118",
            "telephone_number": "415-295-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 VICENTE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162923",
            "telephone_number": "415-681-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "VINCENT",
        "middle_name": "WING CHING",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT125206",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT97966",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.