Individual
ALYSSA JAE YOUN JUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
508 PORTER ST APT 8, GLENDALE, CA 91205-1958
(818) 926-8896
Mailing address
508 PORTER ST APT 8, GLENDALE, CA 91205-1958
(818) 926-8896
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
451406
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98555773D
LA CARE PLAN
CA
Enumeration date
07/14/2021
Last updated
07/14/2021
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