Individual
IFAN WU AMBROSIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PPS
Contact information
Practice address
23852 BRANT LN, LAGUNA NIGUEL, CA 92677-1342
(949) 874-0434
Mailing address
23852 BRANT LN, LAGUNA NIGUEL, CA 92677-1342
(949) 874-0434
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
CA
Other
Enumeration date
11/01/2021
Last updated
11/01/2021
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