Healthcare Provider Details

I. General information

NPI: 1023923307
Provider Name (Legal Business Name): KATHLEEN JULIA DONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 FULTON ST
PALO ALTO CA
94301-1325
US

IV. Provider business mailing address

428 FULTON ST
PALO ALTO CA
94301-1325
US

V. Phone/Fax

Practice location:
  • Phone: 650-665-1106
  • Fax:
Mailing address:
  • Phone: 650-665-1106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG59622
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: