MEDICARE: ERICA WONG OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	23222	CA
2	225X00000X	Occupational Therapist	018556	NY

General Provider Information

NPI Number	:	1689099236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA WONG OTR/L

Provider Business Mailing Address
First Line	:	3000 PARKER RD
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94806-2742
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 PARKER RD
Second Line	:
City	:	RICHMOND
State	:	CA
Zip	:	94806-2742
Country	:	US
Telephone Number	:	510-307-4630
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2014
Last Update Date	:	03/10/2026

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