Provider Demographics
NPI:1073701694
Name:WONG, DEBBIE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBBIE
Middle Name:ANN
Last Name:WONG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15515 CRISTALINO ST.
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745
Mailing Address - Country:US
Mailing Address - Phone:626-961-6708
Mailing Address - Fax:
Practice Address - Street 1:9864 BALDWIN PLACE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731
Practice Address - Country:US
Practice Address - Phone:626-433-1311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health