Michele Wang, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A115102 Issued in CA

Practice address

6200 Wilshire Blvd Ste 1410
Los Angeles, CA 90048-5815

Phone

(925) 282-1778

Fax

(415) 296-5299

NPI assigned

Apr 7, 2008

Last updated

Aug 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Michele Wang MD Inc. Professional name

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.michelewang@148377.advancedmd-direct.com

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.

• County of Fresno

  dba Fresno County Department of Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fresno, CA
  • NPI 1770538001

  Single Specialty

  Medicare reassignment NPD
• Bluebonnet Trails Community MHMR Center

  dba Bluebonnet Trails Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Round Rock, TX
  • NPI 1730135864

  Single Specialty

  Medicare reassignment NPD
• Burke Center

  • Psychiatry Physician
  • Lufkin, TX
  • NPI 1396792420

  Single Specialty

  Medicare reassignment NPD
• Camino Real Community MHMR Center

  dba Camino Real Community Services

  • Case Management Agency
  • Lytle, TX
  • NPI 1154411262

  Single Specialty

  Medicare reassignment NPD
• Heart of Texas Region MHMR Center

  dba Heart of Texas Behavioral Health Network

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waco, TX
  • NPI 1639399132

  Single Specialty

  Medicare reassignment NPD
• Helen Farabee Centers

  • Community/Behavioral Health Agency
  • Wichita Falls, TX
  • NPI 1457479511

  Single Specialty

  Medicare reassignment NPD
• The Gulf Coast Center

  • Psychiatry Physician
  • League City, TX
  • NPI 1245285899

  Single Specialty

  Medicare reassignment NPD
• Michele Wang MD Inc

  dba Michele Wang, MD

  • Psychiatry Physician
  • Aiea, HI
  • NPI 1013395862

  Single Specialty

  NPD Authorized official
• Pacific Coast Psychiatric Associates Inc

  dba Lifestance Health

  • Clinical Psychologist
  • Scottsdale, AZ
  • NPI 1023125465

  CA

  Medicare reassignment
• County of Fresno

  • State or Local Public Health Clinic/Center
  • Fresno, CA
  • NPI 1174606420

  Single Specialty

  NPD
• Bluebonnet Trails Community MHMR Center

  dba Bluebonnet Trails Community Services

  • Rural Health Clinic/Center
  • La Grange, TX
  • NPI 1518536309
  NPD

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1942473442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD STE 1410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485815",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD STE 1410",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485815",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99-128 Aiea Heights Dr Ste 109",
            "address_purpose": "LOCATION",
            "city": "Aiea",
            "state": "HI",
            "postal_code": "96701",
            "country_code": "US",
            "telephone_number": "424-234-3066",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23823 Malibu Rd",
            "address_2": "StSq 133",
            "address_purpose": "LOCATION",
            "city": "Malibu",
            "state": "CA",
            "postal_code": "902654628",
            "country_code": "US",
            "telephone_number": "424-234-3066",
            "fax_number": "424-256-3394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1356 Lusitana St Fl 4",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968132409",
            "country_code": "US",
            "telephone_number": "808-586-1738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANG",
        "first_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD18720",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "Q1533",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A115102",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "248064N",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD 18720",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340090501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "WANG MD INC.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Marilene Beth Wang, MD
• Mark Chang Wang
• Mathew Yen Wang, MD
• Melody T Wang
• Michael Wang, MD
• Michelle Wang, MD
• Mingwu Wang, MD, PHD
• Nahla Wang, AGPCNP
• Nan Wang, AMFT, APCC
• Nina Wang

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.