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Individual

CHARLENE JOY UMAYAM LAVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
77 N SAN MATEO DR STE 2, SAN MATEO, CA 94401-2853
(650) 343-5678
Mailing address
124 PARK BLVD APT 1, MILLBRAE, CA 94030-1254

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
296261
CA

Other

Enumeration date
08/06/2019
Last updated
08/06/2019
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