Individual
JENNISE MANZO
Active
Sole proprietor
No
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
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/12/2025
Last updated
03/12/2025
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