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General NPI Number Information
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NPI Number | 1386728574
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Entity Type | Individual
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Provider Name | STEPHANIE K KONG PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 6600 BRUCEVILLE RD
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City | SACRAMENTO
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State | CA
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Zip | 95823-4671
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Country | US
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Telephone | 916-688-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 KAPIOLANI BLVD SUITE 1306
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City | HONOLULU
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State | HI
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Zip | 96814-3801
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Country | US
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Telephone | 808-949-7444
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Fax | 808-949-6262
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY761
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 25125
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License Number State | CA
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