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Individual

EDREANN JILL SORIBEN GALICINAO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9724 WINTERGREEN CT, STOCKTON, CA 95209-5184
(209) 200-6798
Mailing address
PO BOX 2544, LODI, CA 95241-2544

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
437985
CA

Other

Enumeration date
06/15/2020
Last updated
06/15/2020
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