Organization
STEM COGNITIVE AND PSYCHOLOGICAL REHABILITATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANIE SIM WONG PHD (DIRECTOR)
(650) 549-1241
Entity
Organization
Contact information
Practice address
1700 S AMPHLETT BLVD STE 201, SAN MATEO, CA 94402-2717
(650) 549-1241
Mailing address
1700 S AMPHLETT BLVD STE 201, SAN MATEO, CA 94402-2717
(650) 549-1241
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22759
CA PSYCHOLOGY LICENSE
CA
Enumeration date
09/04/2019
Last updated
01/21/2020
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