Active NPI
Audrey McKenna Wong, OTR/L
- Occupational Therapist
- Sunnyvale, CA
National Provider Identifier
1932945821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 25629
- Practice address
- 797 E Fremont Ave
Sunnyvale, CA 94087-2805 - Phone
- (408) 738-4880
- NPI assigned
- Jul 1, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 25629 | CA | Primary |
Addresses
Primary practice location
797 E Fremont Ave
Sunnyvale, CA 94087-2805
Mailing address
1962 Laver CT
Los Altos, CA 94024-6767
Phone (650) 823-9714
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 |
|---|---|---|---|
| 25629 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1932945821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1962 LAVER CT",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940246767",
"telephone_number": "650-823-9714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "797 E FREMONT AVE",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940872805",
"telephone_number": "408-738-4880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "AUDREY",
"middle_name": "MCKENNA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-01",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "25629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.