Individual
AZENETH VICTORIA WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
470 E 3RD ST, LOS ANGELES, CA 90013-1629
(213) 620-5712
Mailing address
470 E 3RD ST, LOS ANGELES, CA 90013-1629
(213) 620-5712
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
26724
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/20/2020
Last updated
12/02/2024
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