Provider Demographics
NPI:1164897104
Name:TONG, KATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:TONG
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 1:4208 ROSEDALE HWY STE 302-130
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6170
Mailing Address - Country:US
Mailing Address - Phone:909-276-4545
Mailing Address - Fax:
Practice Address - Street 1:3000 W CECIL AVE
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-1821
Practice Address - Country:US
Practice Address - Phone:661-721-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
CAPSY32011103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty