Individual
IVORY ADANZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 E MARCH LN STE D480, STOCKTON, CA 95210-6681
(209) 954-3200
Mailing address
1801 E MARCH LN STE D480, STOCKTON, CA 95210-6681
(209) 954-3200
Taxonomy
Speciality
Code
Description
License number
State
363LX0106X
Occupational Health Nurse Practitioner
Primary
95001966
CA
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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