Individual
MRS. DENISE KATHLEEN STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8660
Mailing address
2227 BARNACLE CT, STOCKTON, CA 95206-5912
(209) 234-5701
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT28140
CA
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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