Individual
JENNIFER ELIZABETH PTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6333 PACIFIC AVE # 261, STOCKTON, CA 95207-3713
(209) 981-3299
Mailing address
6333 PACIFIC AVE # 261, STOCKTON, CA 95207-3713
(209) 981-3299
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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