Provider Demographics
NPI:1881815249
Name:WONG, CATHY JANE (DC)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:JANE
Last Name:WONG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17161 GOLDENWEST ST STE H
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-5480
Mailing Address - Country:US
Mailing Address - Phone:714-847-4995
Mailing Address - Fax:714-847-7110
Practice Address - Street 1:17161 GOLDENWEST ST STE H
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-5480
Practice Address - Country:US
Practice Address - Phone:714-847-4995
Practice Address - Fax:714-847-7110
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21610111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition