Individual
JOHN CAMPOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN, LPT
Contact information
Practice address
541 S HAM LN, LODI, CA 95242-3059
(209) 224-8940
Mailing address
10420 CARNEGIE CT, STOCKTON, CA 95209-3752
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
VN260740
CA
164X00000X
Licensed Vocational Nurse
Primary
VN260740
CA
167G00000X
Licensed Psychiatric Technician
PT36061
CA
Other
Enumeration date
12/24/2012
Last updated
01/17/2025
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