Provider Demographics
NPI:1962618496
Name:WON, SUETFEI NG (NP)
Entity type:Individual
Prefix:
First Name:SUETFEI
Middle Name:NG
Last Name:WON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SUETFEI
Other - Middle Name:NG
Other - Last Name:WON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, MSN, ACNP-BC
Mailing Address - Street 1:2315 STOCKTON BLVD
Mailing Address - Street 2:HOUSESTAFF BUILDING
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2201
Mailing Address - Country:US
Mailing Address - Phone:916-734-7211
Mailing Address - Fax:
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:HOUSESTAFF BUILDING
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-734-7211
Practice Address - Fax:916-734-0432
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11502363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1962618496OtherNPI