Individual
JULIE THAMMAVONGSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
409 CAMINO DEL RIO S STE 201, SAN DIEGO, CA 92108-3505
(619) 346-4020
Mailing address
409 CAMINO DEL RIO S STE 201, SAN DIEGO, CA 92108-3505
(619) 346-4020
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
04/18/2024
Last updated
04/16/2025
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