Individual
MIMI WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
870 MARKET ST, SUITE 744, SAN FRANCISCO, CA 94102-3099
(415) 857-1157
Mailing address
PO BOX 5330, SOUTH SAN FRANCISCO, CA 94083-5330
(415) 857-1157
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY25379
CA
Other
Enumeration date
11/20/2006
Last updated
06/26/2014
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