Individual
DARA ANNE AKIKO FONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 BEAUMONT AVE, SAN FRANCISCO, CA 94118-4208
(415) 244-2846
Mailing address
103 BEAUMONT AVE, SAN FRANCISCO, CA 94118-4208
(415) 244-2846
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
21097
CA
Other
Enumeration date
08/31/2020
Last updated
05/13/2021
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