MS. SO-FONG WONG (NPI# 1043290703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043290703 |
| Entity Type | Individual |
| Full Name | MS. SO-FONG WONG |
| Credential | FNP, CNS, CDE |
| Practice Address |
5050 Crenshaw Rd Ste 100 Pasadena TX 77505-3138 |
| Practice Telephone | 2814871000 |
| Practice Fax Number | 8323994110 |
| Mailing Telephone | 2814871000 |
| Mailing Fax Number | 8323994110 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2016-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
21210407 | TX | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP110586 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
654824 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
AP110586 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
654824 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PTAN | CN8558 | 01 | |
| TPI | 093873001 | 01 |
| Street Address |
5050 CRENSHAW RD STE 100 |
| City | PASADENA |
| State | TX |
| Zip Code | 77505-3138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457349847 | Hal B Boone | Family Medicine | 5050 Crenshaw Rd, Suite 100, Pasadena, TX 77505-3139 | 2005-10-10 |
| 1538158563 | Gastroenterology Diagnostic Clinic | Internal Medicine | 5050 Crenshaw Rd, #200, Pasadena, TX 77505-3139 | 2005-10-21 |
| 1174512131 | Maurice S Haddad | Internal Medicine | 5050 Crenshaw Rd, #200, Pasadena, TX 77505-3139 | 2005-10-20 |
| 1861480204 | Silvia Boccardo-sabatini | Internal Medicine | 5050 Crenshaw Rd, Ste 100, Pasadena, TX 77505-3139 | 2005-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545742 | Travis Jones | Pharmacist | 6767 Spencer Highway, Pasadena, TX 77505 | 2020-10-16 |
| 1952872905 | Bay Area Internal Medicine Care Pllc | Internal Medicine | Baywood Crossing Rehabilitation and Healthcare Center, 5020 Space Center Blvd., Pasadena, TX 77505 | 2018-12-16 |
| 1750851325 | Leslie Jackson | Nurse Practitioner | 7106 Spencer Highway, Pasadena, TX 77505 | 2018-11-27 |
| 1093297459 | Hieu Ngoc Minh Hutt | Occupational Therapy Assistant | 4900 East Sam Houston Pkwy S, Pasadena, TX 77505 | 2018-09-02 |
| 1780189142 | Basewave Properties, Pllc | Psychiatry & Neurology | 4808 Fairmont Pkwy, #404, Pasadena, TX 77505 | 2018-03-28 |
| 1720596141 | Lyanne Marlen Fernandez | Specialist/Technologist | 6565 Spencer Hwy Apt 1114, Pasadena, TX 77505 | 2018-01-19 |
| 1073069811 | Sng - Pasadena Dialysis Center Lp | Clinic/Center | 5040 Crenshaw Rd, Ste 200, Pasadena, TX 77505 | 2016-08-31 |
| 1235683418 | Sharon Li | Nurse Practitioner | 4001 Preston Rd #100, Pasadena, TX 77505 | 2016-08-05 |
| 1225493687 | Skkz, Inc. | Clinic/Center | 6415 Fairmont Pkwy, Ste A, Pasadena, TX 77505 | 2015-12-29 |
| 1982026530 | Aerocare Home Medical, Inc. | Durable Medical Equipment & Medical Supplies | 5041 Spencer Hwy, Suite 603, Pasadena, TX 77505 | 2014-01-16 |
| Find all providers in zip 77505 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092504 | Kyle Kettle | Nurse Practitioner | 5030 Crenshaw Rd Ste 120, Pasadena, TX 77505-3141 | 2020-10-30 |
| 1013516640 | Heather Mekins | Nurse Practitioner | 721 Bridge Dr, Pasadena, MD 21122-4553 | 2020-10-24 |
| 1891394953 | Tammy Jean Bobbitt-gray | Nurse Practitioner | 10801 Choate Rd, Pasadena, TX 77507-1503 | 2020-10-20 |
| 1467067447 | Lizette Cabral | Nurse Practitioner | 1144 N Mentor Ave, Pasadena, CA 91104-3824 | 2020-09-15 |
| 1679188304 | Kimberly Yam | Nurse Practitioner | 1575 N Lake Ave Ste 208, Pasadena, CA 91104-2340 | 2020-09-10 |
| 1215569785 | Kristine Elizabeth Chesney | Nurse Practitioner | 1288 Holmespun Dr, Pasadena, MD 21122-2578 | 2020-02-12 |
| 1598304958 | Sophia A Phillip | Nurse Practitioner | 65 N Madison Ave Ste 800, Pasadena, CA 91101-2038 | 2020-01-03 |
| 1831748359 | Altagracia Garza | Nurse Practitioner | 908 Southmore Ave Ste 130, Pasadena, TX 77502-1100 | 2019-09-06 |
| 1548817919 | Ansela Chaluparambil | Nurse Practitioner | 3326 Watters Rd Bldg D, Pasadena, TX 77504-2053 | 2019-08-21 |
| 1972155828 | Michelle Elizabeth Hinkey | Nurse Practitioner | 8109 Ritchie Hwy # 100, Pasadena, MD 21122-6917 | 2019-07-11 |
| Find all providers in PASADENA | ||||
Please comment or provide details below to improve the information on MS. SO-FONG WONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.