Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 103G00000X | Clinical Psychologist | PSY29266 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY29266 | CA |
N | 225400000X | Rehabilitation Practitioner | ||
N | 225C00000X | Rehabilitation Counselor |
NPI | 1093036576 |
---|---|
Provider Name | Dr. Erica Wan Sze Fung |
First Address | Rosemead, CA 91770-1934 |
Second Address | Rosemead, CA 91770-1934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2010 |
Last Update Date | 27/07/2017 |