Individual
SOPHIA LIN HARRISON-WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1466 LINCOLN AVE, SAN RAFAEL, CA 94901-2021
(415) 457-3755
Mailing address
1466 LINCOLN AVE, SAN RAFAEL, CA 94901-2021
(415) 457-3755
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21857
CA
101YP2500X
Professional Counselor
Primary
20058
CA
106S00000X
Behavior Technician
—
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2019
Last updated
07/29/2025
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