| Richard Wong, | |
|
2271 Alpine Blvd Ste A, Alpine, CA 91901-1101 | |
| (520) 979-1497 | |
| Not Available |
| Full Name | Richard Wong |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 2271 Alpine Blvd Ste A, Alpine, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487320214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC-20151 (Arizona) | Secondary |
| 101YP2500X | Counselor - Professional | 16962 (California) | Primary |
| Entity Name | Fusion Care Group A Psychological Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275177982 PECOS PAC ID: 8921433590 Enrollment ID: O20210727003602 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard Wong, 1717 Ocean Park Blvd Apt 5, Santa Monica, CA 90405-4941 Ph: (520) 979-1497 | Richard Wong, 2271 Alpine Blvd Ste A, Alpine, CA 91901-1101 Ph: (520) 979-1497 |
Ashley Nicole Lairson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2120 Alpine Blvd, Alpine, CA 91901 Phone: 619-722-7319 Fax: 619-722-6327 | |
Jane F Smith, PPS SCHOOL COUNSELOR Counselor Medicare: Not Enrolled in Medicare Practice Location: 2320 Tavern Rd, Alpine, CA 91901 Phone: 619-445-8676 Fax: 619-445-1420 | |
Erin M Mcgowan-robertson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2271 Alpine Blvd Ste A, Alpine, CA 91901 Phone: 619-448-1216 | |
Alyssa Louise Pesce, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2120 Alpine Blvd, Alpine, CA 91901 Phone: 619-445-2644 | |
Christa Marie Mapes, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2271 Alpine Blvd Ste A, Alpine, CA 91901 Phone: 267-879-9651 | |
Leslee-anne Sesno, LCSW Counselor Medicare: Medicare Enrolled Practice Location: 2271 Alpine Blvd Ste A, Alpine, CA 91901 Phone: 888-688-0248 | |
Tiziana Tarquinio, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2120 Alpine Blvd, Alpine, CA 91901 Phone: 619-576-9000 |