Individual
DIANE SAMS PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1429 W FREMONT ST, STOCKTON, CA 95203-2635
(209) 546-7764
(209) 546-7785
Mailing address
1429 W FREMONT ST, STOCKTON, CA 95203-2635
(209) 546-7764
(209) 546-7785
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20351
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20351
—
CA
Enumeration date
04/04/2011
Last updated
07/29/2014
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