Individual
JUANITA L WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3491 KURTZ ST, SAN DIEGO, CA 92110-4430
(619) 320-2404
Mailing address
3491 KURTZ ST STE 150, SAN DIEGO, CA 92110-4430
(619) 320-2404
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT25113
CA
Other
Enumeration date
07/20/2010
Last updated
09/19/2023
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