Individual
MEGAN MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2291 W MARCH LN, STOCKTON, CA 95207-6652
(209) 406-4337
Mailing address
2291 W MARCH LN, STOCKTON, CA 95207-6652
(209) 406-4337
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
CA
Other
Enumeration date
02/24/2020
Last updated
02/24/2020
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