Individual
STEPHANIE HONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5311 DERRY AVE STE I, AGOURA HILLS, CA 91301-5069
(818) 707-2523
Mailing address
24292 PALO VERDE DR, VALENCIA, CA 91354-1554
(661) 733-1416
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
39134
CA
2255A2300X
Athletic Trainer
2000001728
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39134
PT LICENSE
CA
Enumeration date
08/06/2014
Last updated
03/11/2020
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