Individual
JEONG M NAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28677 PARKSIDE DR, VALENCIA, CA 91354-3075
(213) 700-4112
Mailing address
28677 PARKSIDE DR, VALENCIA, CA 91354-3075
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6522
CA
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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