Individual
BARBARA R FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
4626 WILLOW RD, SUITE 200, PLEASANTON, CA 94588-2710
(925) 463-0470
(925) 463-0473
Mailing address
4626 WILLOW RD, SUITE 200, PLEASANTON, CA 94588-2710
(925) 463-0470
(925) 463-0473
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 4082
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT 4082
CA LICENSE
CA
01
—
P00433490
MEDICARE RAILROAD
CA
Enumeration date
10/02/2006
Last updated
03/06/2014
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