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General NPI Number Information
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NPI Number | 1396974788
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Entity Type | Individual
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Provider Name | PHILIP HONG TONG LICENSED MFT
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Gender | Male
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 408 LOMITA AVE
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City | MILLBRAE
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State | CA
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Zip | 94030-1118
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Country | US
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Telephone | 650-922-7503
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Fax | 650-922-7503
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Provider Business Mailing Address
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Address Line | PO BOX 226
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City | MILLBRAE
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State | CA
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Zip | 94030-0226
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Country | US
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Telephone | 650-922-7503
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 67175
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 82205
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License Number State | CA
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