Healthcare Provider Details

I. General information

NPI: 1740507870
Provider Name (Legal Business Name): WING YU MOK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 04/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 S ORANGE AVE
MONTEREY PARK CA
91755-5724
US

IV. Provider business mailing address

1428 S ORANGE AVE
MONTEREY PARK CA
91755-5724
US

V. Phone/Fax

Practice location:
  • Phone: 408-203-3943
  • Fax:
Mailing address:
  • Phone: 408-203-3943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: