Individual
MRS. JUSTINE LARAYA IONGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, MA
Contact information
Practice address
50 EMBARCADERO RD, PALO ALTO, CA 94301-2321
(707) 319-4497
Mailing address
2340 RALMAR AVE, EAST PALO ALTO, CA 94303-1038
(707) 319-4497
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000004148
CA
Other
Enumeration date
09/17/2018
Last updated
09/17/2018
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