Individual
STACY FEARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8750
Mailing address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8750
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
37059
CA
Other
Enumeration date
08/06/2014
Last updated
08/06/2014
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