Justine Laraya Iongi, ATC, MA
Specialist/Technologist, Athletic Trainer in Palo Alto, CA. Individual provider (NPI-1).
NPI number1326522327
StatusActive
Last updated in NPPESSep 17, 2018
Details
- NPI
- 1326522327
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Justine Laraya Iongi
- Credential
- ATC, MA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 17, 2018
- Last updated
- Sep 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2000004148 | CA | Yes |
Practice location
50 Embarcadero RdPalo Alto, CA 94301-2321
Phone 707-319-4497
Mailing address
2340 Ralmar AveEast Palo Alto, CA 94303-1038
Phone 707-319-4497
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