Healthcare Provider Details

I. General information

NPI: 1750986790
Provider Name (Legal Business Name): RACHAEL WONG PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 S LINDEN AVE
SOUTH SAN FRANCISCO CA
94080-6407
US

IV. Provider business mailing address

3 S LINDEN AVE
SOUTH SAN FRANCISCO CA
94080-6407
US

V. Phone/Fax

Practice location:
  • Phone: 650-238-1500
  • Fax:
Mailing address:
  • Phone: 650-238-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT299457
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: