Provider Demographics
NPI:1063514511
Name:WONG, DEEANN YUK-HAN (MD)
Entity type:Individual
Prefix:
First Name:DEEANN
Middle Name:YUK-HAN
Last Name:WONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 DEVONSHIRE DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5136
Mailing Address - Country:US
Mailing Address - Phone:760-753-2600
Mailing Address - Fax:760-301-0038
Practice Address - Street 1:1011 DEVONSHIRE DR
Practice Address - Street 2:SUITE D
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5136
Practice Address - Country:US
Practice Address - Phone:760-753-2600
Practice Address - Fax:760-301-0038
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0624622084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry