Healthcare Provider Details

I. General information

NPI: 1255249918
Provider Name (Legal Business Name): ELIZABETH WONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 W LEMON AVE
ARCADIA CA
91007-7944
US

IV. Provider business mailing address

335 GENOA ST UNIT E
MONROVIA CA
91016-7432
US

V. Phone/Fax

Practice location:
  • Phone: 626-821-8351
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number20201
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: