Individual
MS. MICHELLE Y STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
23,500 KASSON RD, TRACY, CA 95378
(209) 835-4141
Mailing address
P.O. BOX 400, 23,500 KASSON ROAD, TRACY, CA 95378
(209) 835-4141
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA17300
CA
Other
Enumeration date
01/14/2008
Last updated
01/14/2008
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