Individual
MARIA TRUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
541 S HAM LN STE A, LODI, CA 95242-3530
(209) 553-0798
Mailing address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8842
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
167G00000X
Licensed Psychiatric Technician
Primary
PT42019
CA
Other
Enumeration date
07/08/2020
Last updated
12/12/2023
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