Individual
ALYSSA TENNENBAUM GONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LAC, CDCES
Contact information
Practice address
2634 PIEDMONT AVE, BERKELEY, CA 94704-3413
(310) 749-1888
Mailing address
2634 PIEDMONT AVE, BERKELEY, CA 94704-3413
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
636958
—
171100000X
Acupuncturist
17272
CA
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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