Individual
JUSTINE LI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
235 AGATE WAY, HERCULES, CA 94547-1750
(510) 799-3706
Mailing address
235 AGATE WAY, HERCULES, CA 94547-1750
(510) 334-1206
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2015
Last updated
04/20/2015
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