Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | OT19034 | CA |
Y | 225X00000X | Occupational Therapist | OT19034 | CA |
N | 225XG0600X | Occupational Therapist - Gerontology | OT19034 | CA |
N | 225XH1200X | Occupational Therapist - Hand | OT19034 | CA |
NPI | 1245800127 |
---|---|
Provider Name | Woo Yang Chun |
First Address | Ladera Ranch, CA 92694-0890 |
Second Address | Ladera Ranch, CA 92694-0890 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2021 |
Last Update Date | 01/07/2021 |