Provider Demographics
NPI:1770702698
Name:KAO, WAYNE (PSYD)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:
Last Name:KAO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:WEN YU
Other - Middle Name:
Other - Last Name:KAO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:9353 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-1934
Mailing Address - Country:US
Mailing Address - Phone:626-940-8670
Mailing Address - Fax:626-287-0168
Practice Address - Street 1:9353 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-1934
Practice Address - Country:US
Practice Address - Phone:626-940-8670
Practice Address - Fax:626-287-0168
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24143103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical