STACY LYNN WONG (NPI# 1447428412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447428412 |
| Entity Type | Individual |
| Full Name | STACY LYNN WONG |
| Credential | DPT |
| Practice Address |
2405 Shadelands Dr Walnut Creek CA 94598-2444 |
| Mailing Address |
Po Box 31396 Walnut Creek CA 94598-8396 |
| Practice Telephone | 9259398585 |
| Practice Fax Number | 9259332709 |
| Mailing Telephone | 9259398585 |
| Mailing Fax Number | 9259332709 |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2014-03-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251S0007X |
Physical Therapist Specialization: Sports |
33995 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063908317 | Stacy Tennille Wong | Registered Nurse | 1275 York Ave, New York, NY 10065-6007 | 2018-07-10 |
| 1982083416 | Stacy Wong | Plastic Surgery | 2401 S 31st St, Temple, TX 76508-0001 | 2015-05-29 |
| 1174891568 | Stacy Nicole Wong | Nurse Practitioner | 505 Parnassus Ave, Rm M779, San Francisco, CA 94143-0112 | 2011-12-13 |
| 1386956241 | Stacy Wong | Physical Therapist | 3004 W Faidley Ave, Grand Island, NE 68803-4109 | 2010-07-08 |
| 1942532080 | Stacy P Wong | Pharmacist | 1275 York Ave, Pharmacy Dept, New York, NY 10065-6007 | 2010-01-29 |
| Street Address |
2405 SHADELANDS DR |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94598-2444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316939556 | Sequoia Surgical Center Lp | Clinic/Center | 2405 Shadelands Dr, Suite 200, Walnut Creek, CA 94598-2444 | 2005-08-15 |
| 1306499272 | Kevin Byrne | Physician Assistant | 2405 Shadelands Dr, Walnut Creek, CA 94598-2444 | 2019-07-19 |
| 1881062750 | Zachary Symmes | Physician Assistant | 2405 Shadelands Dr, Walnut Creek, CA 94598-2444 | 2015-09-09 |
| 1174914410 | Anna Geller | Registered Nurse | 2405 Shadelands Dr, Walnut Creek, CA 94598-2444 | 2015-02-09 |
| 1255720025 | Gayle Fenner | Physician Assistant | 2405 Shadelands Dr, Walnut Creek, CA 94598-2444 | 2015-01-16 |
| 1689075236 | Michael Francis Cadette | Physician Assistant | 2405 Shadelands Dr, Walnut Creek, CA 94598-2444 | 2014-09-12 |
| 1508270075 | Richard Friedell | Physical Therapist | 2405 Shadelands Dr, Walnut Creek, CA 94598-2444 | 2014-06-12 |
| 1235562489 | Mario Pisani | Physical Therapist | 2405 Shadelands Dr, Walnut Creek, CA 94598-2444 | 2013-08-12 |
| 1922379940 | Bronwyn Fevaleaki | Physical Therapist | 2405 Shadelands Dr, Walnut Creek, CA 94598-2444 | 2012-01-23 |
| 1891083408 | Mariel P Heller-benson | Physician Assistant | 2405 Shadelands Dr, Walnut Creek, CA 94598-2444 | 2011-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639716608 | Tasnim Diaf Moulton | Counselor | 2730 Shadelands Drive, Walnut Creek, CA 94598 | 2019-12-09 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1184108367 | Brett Heflin Woodrufff | Behavior Technician | 2730 Shandeland Dr. Building 10, Walnut Creek, CA 94598 | 2018-09-24 |
| 1710411640 | Mandy Wei | Pharmacist | 2880 Shadeland Dr, Suite 201, Walnut Creek, CA 94598 | 2017-04-18 |
| 1437683497 | Hayley Miller | Student in an Organized Health Care Education/Training Program | 2204 Lomond Lane, Walnut Creek, CA 94598 | 2017-04-17 |
| 1043601594 | Marlene Perez Riedel | Nurse Practitioner | 450 North Wiget Lane, Walnut Creek, CA 94598 | 2015-02-05 |
| 1922418904 | Dante Michael Sorrentino | Ophthalmology | Kaiser Permanente Park Shadelands Medical Offices, 320 Lennon Lane, Walnut Creek, CA 94598 | 2014-04-30 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1174954192 | Paul Mead | Orthopaedic Surgery | 2405 Shadelands Dr Ste 300, Walnut Creek, CA 94598 | 2013-12-01 |
| Find all providers in zip 94598 | ||||
| Taxonomy Code | 2251S0007X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194048363 | Thomas L Clennell | Physical Therapist | 100 N Wiget Ln, Ste 200, Walnut Creek, CA 94598-5988 | 2010-03-02 |
| 1962686881 | Michelle Cappello | Physical Therapist | 100 N Wiget Ln, Suite 200, Walnut Creek, CA 94598-5988 | 2007-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104443837 | Coastal Physical Therapy and Sports Rehabilitation | Physical Therapist | 258 Lombard St, Thousand Oaks, CA 91360-5806 | 2020-06-29 |
| 1992335509 | Ashton Pickle | Physical Therapist | 150 Loma Ln, San Clemente, CA 92672-4721 | 2020-01-23 |
| 1083262976 | Lana Aziz-oglii | Physical Therapist | 2791 Brimhall Dr, Los Alamitos, CA 90720-4905 | 2019-09-03 |
| 1174080931 | Mmt Physical Therapy Inc | Physical Therapist | 3040 Larkin St, San Francisco, CA 94109-1116 | 2019-02-27 |
| 1649737982 | La Orthopedic and Pediatric Physical Therapy | Physical Therapist | 16055 Ventura Blvd Ste 825, Encino, CA 91436-2617 | 2019-02-22 |
| 1225505894 | Haley Tarryn Hawes | Physical Therapist | 12401 Wilshire Blvd Ste 105, Los Angeles, CA 90025-1015 | 2018-10-31 |
| 1629561667 | Jason Chan Hyung Park | Physical Therapist | 2440 W Carson St, Torrance, CA 90501-3146 | 2018-06-13 |
| 1447757125 | Anthony G Tam | Physical Therapist | 5030 Bonita Rd Ste B, Bonita, CA 91902-1700 | 2018-04-10 |
| 1730606468 | Joseph Anthony Santistevan | Physical Therapist | 1975 Maricopa Hwy Spc 19, Ojai, CA 93023-2365 | 2017-08-24 |
| 1124541016 | Max Biessmann | Physical Therapist | 28202 Cabot Rd Ste 150, Laguna Niguel, CA 92677-1250 | 2017-07-21 |
| Find all providers with the same taxonomy | ||||
| City | WALNUT CREEK |
| Zip Code | 94598 |
Please comment or provide details below to improve the information on STACY LYNN 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.