Individual
MISS STACY TENNILLE WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
521 PARNASSUS AVE, SAN FRANCISCO, CA 94143-2206
(415) 514-3785
(415) 476-9516
Mailing address
126 W CARTER DR, GLENDORA, CA 91740-5910
(626) 272-6042
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
762032
CA
163WC0200X
Critical Care Medicine Registered Nurse
730127-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA95002044
CA
Other
Enumeration date
07/10/2018
Last updated
02/05/2026
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