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General NPI Number Information
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NPI Number | 1073402079
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Entity Type | Individual
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Provider Name | AMY WANG
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Gender | Female
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1401 HIGHLAND AVE
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City | DUARTE
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State | CA
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Zip | 91010-2523
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Country | US
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Telephone | 657-321-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1173 JEPSON LN
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City | SOUTH EL MONTE
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State | CA
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Zip | 91733-6803
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 240027357
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License Number State | CA
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