Individual
JENNIE YOONJUNG SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 TILTON DR, SUNNYVALE, CA 94087-2440
(408) 735-7200
Mailing address
2787A MAURICIA AVE, SANTA CLARA, CA 95051-7032
Taxonomy
Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
4911
CA
Other
Enumeration date
07/05/2016
Last updated
07/06/2016
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