Individual
GINA WILBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMFT
Contact information
Practice address
4277 TEHAMA AVE, FREMONT, CA 94538-2636
(510) 366-0908
Mailing address
4277 TEHAMA AVE, FREMONT, CA 94538-2636
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2342
CA
Other
Enumeration date
03/31/2009
Last updated
03/31/2009
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