Provider Demographics
NPI:1083502637
Name:WANG, KAIXIN
Entity type:Individual
Prefix:
First Name:KAIXIN
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:60 CRITTENDEN BLVD APT 432
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4033
Mailing Address - Country:US
Mailing Address - Phone:585-660-9545
Mailing Address - Fax:
Practice Address - Street 1:60 CRITTENDEN BLVD APT 432
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4033
Practice Address - Country:US
Practice Address - Phone:585-660-9545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health