Individual
JUSTIN CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1414 N CALIFORNIA ST # 2, STOCKTON, CA 95202-1515
(209) 468-8700
Mailing address
248 E DOWNS ST, STOCKTON, CA 95204-2006
(209) 373-8805
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42379
CA
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
07/12/2022
Last updated
01/12/2024
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