Individual
DANIELLE PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
9620 CHESAPEAKE DR STE 103, SAN DIEGO, CA 92123-1324
(858) 859-5369
Mailing address
4309 LOMA RIVIERA CT, SAN DIEGO, CA 92110-5504
(714) 495-0930
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-15-02881
CA
225X00000X
Occupational Therapist
Primary
25200
CA
Other
Enumeration date
12/23/2017
Last updated
08/13/2024
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