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Contact Information

STEPHANIE S WONG
4601 DALE RD
MODESTO, CA95356-9718
 Phone: 209-735-5000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Mammography Radiologic Technologist

2471M2300X
 

Radiography Radiologic Technologist

2471C3402X
Indicates primary specialty

NPI Profile & details for STEPHANIE S WONG · (Female)

NPI # 1649844655
Status Active
Credentials
Entity Individual
Enumeration date 05/14/2021
Last updated 01/17/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 00102159
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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