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Individual

PENG VANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
X

Contact information

Practice address
5151 PACIFIC AVE, STOCKTON, CA 95207-6304
(209) 954-5151
Mailing address
5151 PACIFIC AVE, STOCKTON, CA 95207-6304

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42981
CA

Other

Enumeration date
04/09/2025
Last updated
04/09/2025
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