Provider Demographics
NPI:1609980861
Name:WONG, YURIKO INO (MS OTRL CHT)
Entity Type:Individual
Prefix:MRS
First Name:YURIKO
Middle Name:INO
Last Name:WONG
Suffix:
Gender:F
Credentials:MS OTRL CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4045
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942-4045
Mailing Address - Country:US
Mailing Address - Phone:831-649-5318
Mailing Address - Fax:
Practice Address - Street 1:871 CASS ST
Practice Address - Street 2:SUITE 210
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2917
Practice Address - Country:US
Practice Address - Phone:831-655-3621
Practice Address - Fax:831-655-3623
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA241225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26583ZMedicare ID - Type Unspecified
P94227Medicare UPIN