Individual
JESSICA PHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1819
(909) 580-1000
Mailing address
4860 ALMONDWOOD WAY, SAN DIEGO, CA 92130-2784
(858) 649-9778
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT17799
CA
Other
Enumeration date
12/20/2019
Last updated
12/20/2019
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