Organization
STEM COGNITIVE AND PSYCHOLOGICAL REHABILITATION, INC.
Active
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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