Individual
CLONGE WAYNE RAFUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7200 BANCROFT AVE STE 267, OAKLAND, CA 94605-2408
(510) 735-0864
(510) 647-9408
Mailing address
2342 SHATTUCK AVE APT 112, BERKELEY, CA 94704-1517
(510) 735-3004
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/07/2014
Last updated
01/27/2025
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