Provider Demographics
NPI:1790808996
Name:WONG, ALAN LEW (LCSW)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:LEW
Last Name:WONG
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 S 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-4343
Mailing Address - Country:US
Mailing Address - Phone:626-487-1295
Mailing Address - Fax:
Practice Address - Street 1:201 CENTRE PLAZA DRIVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754
Practice Address - Country:US
Practice Address - Phone:213-215-1833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA697601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical