Active NPI
Colleen Wong, OTR/L
- Physical Rehabilitation Occupational Therapist
- Burlingame, CA
National Provider Identifier
1912395039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- 13372
- Practice address
- 1100 Trousdale Dr
Burlingame, CA 94010-3207 - Phone
- (650) 692-3758
- NPI assigned
- Dec 23, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 13372 | CA | |
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 13372 | CA | Primary |
Addresses
Primary practice location
1100 Trousdale Dr
Burlingame, CA 94010-3207
Mailing address
1100 Trousdale Dr
Burlingame, CA 94010-3207
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13372 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419292800000",
"number": "1912395039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 TROUSDALE DR",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940103207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 TROUSDALE DR",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "940103207",
"telephone_number": "650-692-3758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "COLLEEN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-23",
"last_updated": "2014-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "13372",
"primary": false
},
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "CA",
"license": "13372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlingame, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.