MEDICARE: KIANA TYLER WONG

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	101YS0200X	School Counselor
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1942970397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIANA TYLER WONG

Provider Business Mailing Address
First Line	:	8945 GOLF LINKS RD
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94605-4124
Country	:	US
Telephone Number	:	510-317-1444
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 HARBOR RD
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94124-2474
Country	:	US
Telephone Number	:	415-404-2602
Fax Number	:

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

Provider Enumeration Date	:	09/16/2021
Last Update Date	:	01/10/2024

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Directions to “ KIANA TYLER WONG ” Practice Location

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