MRS. AMANDA C. WONGSONEGORO CMT NPI 1649480039

NPI Information

MRS. Amanda C. Wongsonegoro, CMT is a specialist in Petaluma, CA. The provider is 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. MRS. Amanda C. Wongsonegoro, CMT NPI is 1649480039. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

35 PETALUMA BLVD N
PETALUMA, CA
ZIP 94952-001
Phone: (707) 477-5402
Fax: (707) 762-4316

The enumeration date for this NPI number is 5/23/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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