Provider Demographics
NPI:1750428942
Name:WONG, KAY SUN (PHD)
Entity type:Individual
Prefix:DR
First Name:KAY
Middle Name:SUN
Last Name:WONG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KAY
Other - Middle Name:SUN
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 10775
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-0775
Mailing Address - Country:US
Mailing Address - Phone:808-949-8001
Mailing Address - Fax:
Practice Address - Street 1:1600 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 620
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3801
Practice Address - Country:US
Practice Address - Phone:808-949-8001
Practice Address - Fax:808-942-5232
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY-383103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical