Nicole Wong, MSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

ASW95471 Issued in CA

Practice address

260 Maple CT Ste 205
Ventura, CA 93003-9134

Phone

(805) 798-3723

NPI assigned

Dec 16, 2020

Sex

Female

Sole proprietor

Yes

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)

Not 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 and National Provider Directory roles.

• Hamburger Home

  • Community/Behavioral Health Agency
  • Van Nuys, CA
  • NPI 1073643292
  NPD (past)

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1992391643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 LAURA LN",
            "city": "RESEDA",
            "state": "CA",
            "postal_code": "913352488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MAPLE CT STE 205",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930039134",
            "telephone_number": "805-798-3723"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Sepulveda Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914112511",
            "country_code": "US",
            "telephone_number": "818-980-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3580 Wilshire Blvd Ste 800",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900102505",
            "country_code": "US",
            "telephone_number": "213-637-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "NICOLE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW95471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Chung-Yun Wong, M.D.
• Jared Wong, PA
• Jeffrey Alan Wong, MD
• Jill Huang Wong, PHD
• Jonathan S Wong, DDS
• Matthew Woo, MD
• Diane J Wood, C.N.M.
• Frank C Wood, PHARMD
• Lavon Renee Wood
• Moira Wood, MD

• Mental Health Counselor in Ventura, CA
• Providers in Ventura, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.