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Individual

JESSICA D GROOMES-CARMONA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8626 LOWER SACRAMENTO RD, STOCKTON, CA 95210-1834
(209) 478-2487
Mailing address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-0103

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
721889
CA
164X00000X
Licensed Vocational Nurse
Primary
721889
CA

Other

Enumeration date
03/08/2022
Last updated
11/06/2023
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