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Individual

ELIZABETH SHONGLEE WONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4150 CLEMENT ST, SAN FRANCISCO, CA 94121-1545
(707) 583-4012
Mailing address
5539 RAINBOW CIR, SANTA ROSA, CA 95409-4377

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
745456
CA
363LF0000X
Family Nurse Practitioner
23423
CA
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
3363
CA

Other

Enumeration date
05/01/2015
Last updated
05/01/2015
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