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Individual

NAOMI N FUENTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2384 E MAIN ST, STOCKTON, CA 95205-6552
(209) 370-3726
Mailing address
2384 E MAIN ST, STOCKTON, CA 95205-6552
(209) 370-3726

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
202358016727
CA

Other

Enumeration date
07/12/2023
Last updated
07/12/2023
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