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Individual

GLENNA SUNGA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1149 W 190TH ST STE 2300, GARDENA, CA 90248-4350
(310) 892-5812
Mailing address
21111 DOLORES ST SPC 67, CARSON, CA 90745-8214

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA6376
CA

Other

Enumeration date
12/22/2023
Last updated
12/22/2023
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