Provider Demographics
NPI:1437738903
Name:HOANG, JENNY LAP (CMT)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:LAP
Last Name:HOANG
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7941 HILL DR
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-4124
Mailing Address - Country:US
Mailing Address - Phone:626-643-2003
Mailing Address - Fax:
Practice Address - Street 1:600 W MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3362
Practice Address - Country:US
Practice Address - Phone:626-643-2003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-03
Last Update Date:2021-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43024225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist