Peter Ray Wong, LMFT#145324

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT145324 Issued in CA

Practice address

3724 Atherton Rd Ste 215
Rocklin, CA 95765-3717

Phone

(916) 243-0568

NPI assigned

Jul 29, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 12, 2024 through Apr 12, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1790238426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 ATHERTON RD STE 215",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653717",
            "telephone_number": "916-243-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 ATHERTON RD STE 215",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653717",
            "telephone_number": "916-243-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "PETER",
        "middle_name": "RAY",
        "credential": "LMFT#145324",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-29",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT145324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aubrey Resa Wong
• Clifford Thomas Wong, D.D.S., M.S.D.
• Edwin H. Wong, M.D.
• Kenneth C K Wong, DDS
• Melissa Alexandra Wong, DDS
• Serena Wong
• Holli Wood
• Jill Wood
• Lorie J Woodard, NP
• Lisa Woods

• Marriage & Family Therapist in Rocklin, CA
• Providers in Rocklin, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.