| Doctor Name: | DR. SOPHIA J WANG |
| NPI Number: | 1154474294 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | PSY 22403 |
| Business Practice Address: | 77-6425 Kuakini Hwy D-102 Kailua Kona, HI - 967403213 |
| Business Phone Number: | 8083297176 |
| Business Fax Number: | 8083261279 |
| Mailing Address: | Po Box 4938, KAILUA KONA |
| State: | HI |
| Postal Code: | 967454938 |
| Phone Number: | 8083297176 |
| Fax Number: | 8083261279 |
| NPI Enumeration Date: | 01/20/2007 |
| NPI Last Update Date: | 02/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY 22403 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |