Dr. Matthew Wong
Clinical Child & Adolescent Psychologist
870 Emerald Bay Rd # 303 Box #3
South Lake Tahoe
, California 96150-9403
Dr. Matthew Wong
Clinical Child & Adolescent Psychologist
870 Emerald Bay Rd # 303 Box #3
South Lake Tahoe
, California 96150-9403
(415) 806-0275
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About
Features
Specialties
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Dr. Matthew Wong
- 870 Emerald Bay Rd # 303 Box #3
- South Lake Tahoe, CA
- Zip : 96150-9403
- Phone : (415) 806-0275
Second Address
- Dr. Matthew Wong
- 870 Emerald Bay Rd # 303 Box #3
- South Lake Tahoe, CA
- Zip : 96150-9403
- Phone : (415) 806-0275
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 26365 | CA |
National Provider Identifier
| NPI | 1033343017 |
|---|---|
| Provider Name | Dr. Matthew Wong |
| First Address | South Lake Tahoe, CA 96150-9403 |
| Second Address | South Lake Tahoe, CA 96150-9403 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/05/2009 |
| Last Update Date | 11/11/2016 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.