Provider Demographics
NPI:1215237748
Name:WONG YUEN, ANAIS (BA)
Entity type:Individual
Prefix:MS
First Name:ANAIS
Middle Name:
Last Name:WONG YUEN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 WALNUT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-2333
Mailing Address - Country:US
Mailing Address - Phone:650-464-1522
Mailing Address - Fax:
Practice Address - Street 1:1701 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-1727
Practice Address - Country:US
Practice Address - Phone:415-452-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist