Individual
IVANKA CARGONJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTL
Contact information
Practice address
2140 CARLMONT DR, BELMONT, CA 94002-3417
(650) 591-9601
Mailing address
1423 ELM ST, SAN CARLOS, CA 94070-4921
(650) 868-4160
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5728
CA
Other
Enumeration date
04/25/2020
Last updated
04/25/2020
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