Individual
KATY POLONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3607 MAIN ST STE A, FREMONT, CA 94538-4390
(510) 706-9528
Mailing address
3607 MAIN ST STE A, FREMONT, CA 94538-4390
(510) 706-9528
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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