Provider Demographics
NPI:1306002050
Name:KWOK, PEGGY CHINGIN (MFT)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:CHINGIN
Last Name:KWOK
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:CHING IN
Other - Middle Name:
Other - Last Name:KWOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1950 ALAMEDA DE LA PULGAS
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403
Mailing Address - Country:US
Mailing Address - Phone:650-573-2408
Mailing Address - Fax:415-597-8004
Practice Address - Street 1:1950 ALAMEDA DE LA PULGAS
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403
Practice Address - Country:US
Practice Address - Phone:415-775-2636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC53519106H00000X
101Y00000X
CAIMF61072106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor