Individual
DESTINY FLORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4545 GEORGETOWN PL STE A3, STOCKTON, CA 95207-6228
(209) 955-1139
Mailing address
4545 GEORGETOWN PL STE A3, STOCKTON, CA 95207-6228
(209) 955-1139
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
734315
CA
167G00000X
Licensed Psychiatric Technician
734315
CA
Other
Enumeration date
01/27/2025
Last updated
02/20/2025
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