Individual
IVY FUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2813 MONTE CRESTA DR, BELMONT, CA 94002-1336
(650) 703-6546
Mailing address
2813 MONTE CRESTA DR, BELMONT, CA 94002-1336
(650) 703-6546
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
642
CA
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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