Individual
JAMIE MARLENE ANDRADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3141 WENTWORTH DR, STOCKTON, CA 95209-2158
(209) 851-6002
Mailing address
3141 WENTWORTH DR, STOCKTON, CA 95209-2158
(209) 851-6002
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
275722
CA
Other
Enumeration date
11/16/2018
Last updated
11/16/2018
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