Healthcare Provider Details

I. General information

NPI: 1407795131
Provider Name (Legal Business Name): DALLA YEE WONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5595 HUNTINGTON DR N
LOS ANGELES CA
90032-1324
US

IV. Provider business mailing address

560 W MAIN ST STE C #255
ALHAMBRA CA
91801
US

V. Phone/Fax

Practice location:
  • Phone: 323-576-2938
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number28895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: