MICHELLE ANN WONG (NPI# 1336525609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336525609 |
| Entity Type | Individual |
| Full Name | MICHELLE ANN WONG |
| Other Name | MICHELLE ANN AUSILIO |
| Credential | PA-C |
| Practice Address |
200 Mission Blvd 1st Floor Jackson CA 95642-2564 |
| Mailing Address |
1990 N California Blvd Ste 400 Walnut Creek CA 94596-7249 |
| Practice Telephone | 2092237555 |
| Mailing Telephone | 9252255837 |
| Mailing Fax Number | 9252255838 |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-08-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
52720 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275043226 | Michelle Alicia Wong | Social Worker | 6653 S Maryland Ave Apt 2w, Chicago, IL 60637-4257 | 2017-10-04 |
| 1104130061 | Michelle Wong | Optometrist | 505 J. Davis Armistead Bldg, Houston, TX 77204-2020 | 2010-08-03 |
| 1982932331 | Michelle Wong | Pharmacist | 225 N Alhambra Ave Unit 3, Monterey Park, CA 91755-4913 | 2009-11-23 |
| 1053560656 | Michelle W Wong | Optometrist | 6910 S Rainbow Blvd, Suite 102, Las Vegas, NV 89118-3273 | 2008-09-18 |
| 1285698654 | Michelle Sun-mee Wong | Obstetrics & Gynecology | 17510 W. Grand Pkwy S., Suite #430, Sugar Land, TX 77479 | 2006-04-13 |
| 1821697517 | Michelle Elizabeth Wong | Nurse Practitioner | 1468 Madison Ave, New York, NY 10029-6508 | 2020-10-22 |
| 1447887856 | Michelle Wong | Physical Therapist | 222 W 39th Ave, San Mateo, CA 94403-4364 | 2020-03-25 |
| 1679122196 | Michelle Wong | Massage Therapist | 118 Ponahawai St, Hilo, HI 96720-3004 | 2019-09-06 |
| 1407416928 | Michelle Wong | Speech-Language Pathologist | 1891 Station Pkwy Nw, Andover, MN 55304-3341 | 2019-06-17 |
| 1144782319 | Michelle Namekawa Wong | Student in an Organized Health Care Education/Training Program | 1800 N California St, Stockton, CA 95204-6019 | 2019-04-04 |
| Street Address |
200 MISSION BLVD 1ST FLOOR |
| City | JACKSON |
| State | CA |
| Zip Code | 95642-2564 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932180320 | Mark Noel Forrette | Nurse Practitioner | 200 Mission Blvd, Jackson, CA 95642-2564 | 2005-11-11 |
| 1801374434 | Hospitalist Medicine Physicians of California - Jackson, PC | Internal Medicine | 200 Mission Blvd, Jackson, CA 95642-2564 | 2018-08-06 |
| 1932440781 | Surgical Affiliates of California | Surgery | 200 Mission Blvd, Jackson, CA 95642-2564 | 2013-03-04 |
| 1720384589 | Kim Marie Vagt | Dietitian, Registered | 200 Mission Blvd, Jackson, CA 95642-2564 | 2011-01-26 |
| 1063714517 | Mary Michelle Vanfossan | Dietitian, Registered | 200 Mission Blvd, Jackson, CA 95642-2564 | 2010-12-03 |
| 1568779072 | Krystin Granger | Anesthesiology | 200 Mission Blvd, Jackson, CA 95642-2564 | 2010-09-03 |
| 1629396122 | Harkanwal Singh | Hospitalist | 200 Mission Blvd, Jackson, CA 95642-2564 | 2010-05-07 |
| 1821322215 | Radiological Associates of Sacramento Medical Group Inc | Internal Medicine | 200 Mission Blvd, Jackson, CA 95642-2564 | 2009-10-01 |
| 1447494323 | Sutter Valley Hospitals | General Acute Care Hospital | 200 Mission Blvd, Jackson, CA 95642-2564 | 2009-04-23 |
| 1285890319 | Sound Inpatient Physicians Medical Group | Hospitalist | 200 Mission Blvd, Jackson, CA 95642-2564 | 2008-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932666575 | Gold Country Health Initiative, LLC | Family Medicine | 820/830 State Highway 88, Jackson, CA 95642 | 2019-03-01 |
| 1053844902 | Kathryn Erosa | Pharmacist | 515 Highway 49 South, Jackson, CA 95642 | 2017-04-07 |
| 1356882039 | Thomas Alan Bowhay | Clinic/Center | 820 Highway 88, Jackson, CA 95642 | 2017-03-15 |
| 1710130141 | Roland E Womack | Dentist | 511 Sutter St, Jackson, CA 95642 | 2008-10-29 |
| 1508929522 | Stanley M Ordonez | Dentist | 645 New York Ranch Rd, Jackson, CA 95642 | 2006-12-19 |
| 1942374996 | Thomas W Zeiler | Chiropractor | 665 New York Ranch Rd Suite 2, Jackson, CA 95642 | 2006-11-20 |
| 1023188968 | Cordelia Rose Slayter | Physical Therapist | 711 S State Hwy 49, Jackson, CA 95642 | 2006-11-08 |
| 1285744946 | Raleys | Pharmacy | 781 South Highway 49, Jackson, CA 95642 | 2006-08-30 |
| 1316996747 | Robert R. Bussell X | Physical Therapist | 813 Court Street, Ste 2, Jackon, CA 95642 | 2006-05-10 |
| 1861953135 | Chelsea Yule Solutions | Clinic/Center | 230 N Main St, Jackson, CA 95642 | 2019-03-28 |
| Find all providers in zip 95642 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629206784 | Sarah Beth Poplawski | Physician Assistant | 205 N. East Avenue, Emergency Department, Jackson, MI 49201 | 2009-06-29 |
| 1225167356 | Marianne Elizabeth Lapointe | Physician Assistant | 815 Court St Ste 7, Jackson, CA 95642-2154 | 2007-03-05 |
| 1386780237 | Charles F Harris | Physician Assistant | 982 W. Broadway, Jackson, WY 83002 | 2007-01-29 |
| 1427109149 | Coreen Dian Garcia-sweets | Physician Assistant | 3235 E Michigan Ave Ste 100, Jackson, MI 49202-3971 | 2007-01-16 |
| 1861552556 | Marc A Fierro | Physician Assistant | 11333 Prospect Dr Ste 401, Jackson, CA 95642-9311 | 2006-12-11 |
| 1427146539 | James E Abernathy II | Physician Assistant | 294 Sumar Dr, Jackson, TN 38301 | 2006-10-11 |
| 1184633935 | Kelly Elizabeth Graver Pate | Physician Assistant | 9279 Locust St., Jackson, CA 95669 | 2006-08-07 |
| 1548241359 | Byron Michael Breeding | Physician Assistant | 144 Edenwood Dr, Jackson, TN 38301-3827 | 2005-11-09 |
| 1033735709 | Anna Marie Plumley | Physician Assistant | 1325 N West Ave, Jackson, MI 49202-2050 | 2020-06-18 |
| 1093347072 | Jessica Emil Ansara | Physician Assistant | 205 N East Ave, Jackson, MI 49201-1753 | 2020-02-07 |
| Find all providers in JACKSON | ||||
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| 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.