Healthcare Provider Details

I. General information

NPI: 1821223819
Provider Name (Legal Business Name): EUFROCINA SALONGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2009
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2819 CROW CANYON RD SUITE 205
SAN RAMON CA
94583-1655
US

IV. Provider business mailing address

2819 CROW CANYON RD SUITE 205
SAN RAMON CA
94583-1655
US

V. Phone/Fax

Practice location:
  • Phone: 925-264-9810
  • Fax: 925-263-1906
Mailing address:
  • Phone: 925-264-9810
  • Fax: 925-263-1906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License NumberOT 401
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT 401
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: