Active NPI
Lorraine Wong, PHD
- Psychologist
- Menlo Park, CA
National Provider Identifier
1972962397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY27739
- Practice address
- 830 Menlo Ave Ste 200C
Menlo Park, CA 94025-4734 - Phone
- (650) 382-2064
- NPI assigned
- Feb 12, 2016
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY27739 | CA | Primary |
| Clinical Psychologist | 103TC0700X | PSY27739 | CA |
Addresses
Primary practice location
830 Menlo Ave Ste 200C
Menlo Park, CA 94025-4734
Mailing address
492 Gilbert Avenue
Menlo Park, CA 94025
Phone (540) 382-2064
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Oct 1, 2017 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY27739 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1455235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665532800000",
"number": "1972962397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "492 GILBERT AVENUE",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "94025",
"telephone_number": "540-382-2064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 MENLO AVE STE 200C",
"city": "MENLO PARK",
"state": "CA",
"postal_code": "940254734",
"telephone_number": "650-382-2064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "LORRAINE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-12",
"last_updated": "2022-10-12",
"certification_date": "2022-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY27739",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY27739",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menlo Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.