Provider Demographics
NPI:1295928976
Name:TONG, CONNIE CHIA-YING (MS)
Entity type:Individual
Prefix:MISS
First Name:CONNIE CHIA-YING
Middle Name:
Last Name:TONG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:CONNIE
Other - Middle Name:
Other - Last Name:TONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:10808 FOOTHILL BLVD STE 160829
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3889
Mailing Address - Country:US
Mailing Address - Phone:626-325-8124
Mailing Address - Fax:
Practice Address - Street 1:10808 FOOTHILL BLVD STE 160829
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3889
Practice Address - Country:US
Practice Address - Phone:626-325-8124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP15580235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist