Healthcare Provider Details

I. General information

NPI: 1871782656
Provider Name (Legal Business Name): VIVIEN WING-HAN WONG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 HOWE AVE
SACRAMENTO CA
95825-3912
US

IV. Provider business mailing address

39 ARKANSAS ST
SAN FRANCISCO CA
94107-2434
US

V. Phone/Fax

Practice location:
  • Phone: 844-664-2248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW132292
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: