Kathleen Lucile Wong, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT27070 Issued in CA

Practice address

631 S Ham LN
Lodi, CA 95242-3532

Phone

(209) 368-7433

Fax

(209) 368-4219

NPI assigned

Nov 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• TSH Inc.

  dba Lodi Physical Therapy

  • Physical Therapist
  • Lodi, CA
  • NPI 1841396223
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922177484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 W VERNAL WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952031622",
            "telephone_number": "209-368-7433",
            "fax_number": "209-368-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 S HAM LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423532",
            "telephone_number": "209-368-7433",
            "fax_number": "209-368-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "KATHLEEN",
        "middle_name": "LUCILE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT27070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Royce Wisner, M.D.
• Joseph Alexander Woelfel, PH.D., FASCP, R.PH.
• Mary Larkins Woelfel, IBCLC
• Wendy Michele Wold
• Greg Womble
• Kevin Y.S. Wong, D.D.S.
• Leslie NS Wong, DDS
• Regina Fung Guen Wong, M.D.
• Woodbridge Pharmacy
• Gina Buscaglia Woodworth, RD, CNSC, CDCES

• Physical Therapist in Lodi, CA
• Providers in Lodi, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.