Individual
JUSTICE ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3601 PACIFIC AVE, STOCKTON, CA 95211-0110
(209) 476-1959
Mailing address
3601 PACIFIC AVE, STOCKTON, CA 95211-0110
(916) 364-7800
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
07/26/2022
Last updated
09/15/2025
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