Individual
VAN NGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
3939 MONROE AVE APT 124, FREMONT, CA 94536-6903
(408) 229-3582
Mailing address
3939 MONROE AVE APT 124, FREMONT, CA 94536-6903
(408) 229-3582
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
12170
CA
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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