Individual
NICHOLAS WING OR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1411 E 31ST ST, OAKLAND, CA 94602-1018
(650) 888-2939
Mailing address
2117 ENSENADA WAY, SAN MATEO, CA 94403-1227
(650) 888-2939
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
20288
CA
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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