Individual
JERAMY WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
908 TUOLUMNE ST, VALLEJO, CA 94590-4641
(707) 648-8121
Mailing address
849 4TH ST, FAIRFIELD, CA 94533-4501
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
CA
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
—
—
372600000X
Adult Companion
Primary
—
CA
Other
Enumeration date
08/01/2022
Last updated
07/14/2025
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