Provider Demographics
NPI:1346438926
Name:CHEUNG, JONAH MAE
Entity Type:Individual
Prefix:
First Name:JONAH MAE
Middle Name:
Last Name:CHEUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JONAH
Other - Middle Name:MAE
Other - Last Name:SAYSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32138 ELK GROVE CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-4238
Mailing Address - Country:US
Mailing Address - Phone:661-487-2928
Mailing Address - Fax:
Practice Address - Street 1:32138 ELK GROVE CT
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4238
Practice Address - Country:US
Practice Address - Phone:661-487-2928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34344225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist