| Richard Wong, | |
|
3019 Ocean Park Blvd # 644, Santa Monica, CA 90405-3004 | |
| (415) 413-3975 | |
| Not Available |
| Full Name | Richard Wong |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 3019 Ocean Park Blvd # 644, Santa Monica, 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 | 16962 (California) | Primary |
| 101YP2500X | Counselor - Professional | LPC-20151 (Arizona) | Secondary |
| 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, 3019 Ocean Park Blvd # 644, Santa Monica, CA 90405-3004 Ph: (415) 413-3975 | Richard Wong, 3019 Ocean Park Blvd # 644, Santa Monica, CA 90405-3004 Ph: (415) 413-3975 |
Andrew Liberman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1328 2nd St, Santa Monica, CA 90401 Phone: 310-394-6889 | |
Kristen Elaine Mcdermott, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3435 Ocean Park Blvd, Santa Monica, CA 90405 Phone: 310-392-9474 | |
Miss Carly Elizabeth Decerce, RAD-T LEVEL I Counselor Medicare: Not Enrolled in Medicare Practice Location: 1002 Pico Blvd, Santa Monica, CA 90405 Phone: 310-848-7132 | |
Dr. Sarah Kamdar, PSYD Counselor Medicare: Accepting Medicare Assignments Practice Location: 1452 26th St, Ste 102, Santa Monica, CA 90404 Phone: 310-571-8160 | |
Stephen S Reeder, M.A., LPC, LPCC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2121 Cloverfield Blvd Ste 131, Santa Monica, CA 90404 Phone: 310-829-9161 | |
Ariana Gravanis, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 3101 Ocean Park Blvd Ste 309, Santa Monica, CA 90405 Phone: 424-231-6981 | |
Dewayne Lynch, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1328 2nd St, Santa Monica, CA 90401 Phone: 310-395-5855 Fax: 310-453-4817 |