Healthcare Provider Details

I. General information

NPI: 1336546803
Provider Name (Legal Business Name): SHELLEY MEI CHOY WONG M.D., R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2014
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 QUARRY RD
PALO ALTO CA
94304-1419
US

IV. Provider business mailing address

401 QUARRY RD RM 2208
PALO ALTO CA
94304-1419
US

V. Phone/Fax

Practice location:
  • Phone: 650-498-9111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMDR-8099
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86002922
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: