Individual
ELAINE LOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
89 W MARCH LN, STE #1, STOCKTON, CA 95207-5721
(209) 478-2622
Mailing address
89 W MARCH LN, STE #1, STOCKTON, CA 95207-5721
(209) 478-2622
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN557498
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP12548
FURNISHING LICENSE
CA
01
—
RN557498
RN LICENSE
CA
Enumeration date
03/21/2007
Last updated
07/08/2007
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