Individual provider · Type 1 NPI

Amanda C. Wongsonegoro, CMT

Specialist · Petaluma, CA

NPI number 1649480039 Active

Practice location

35 Petaluma Blvd N
Petaluma, CA 94952-3001

Call (707) 477-5402 Map

Fax (707) 762-4316

Mailing address

332 Keokuk St
Petaluma, CA 94952-2729

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1649480039

Amanda C. Wongsonegoro, CMT's National Provider Identifier is 1649480039, issued on May 23, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Petaluma, CA. The record was last updated on Jul 8, 2007.