Individual
MAMOONA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8660
Mailing address
9072 WARM SPRINGS CIR, STOCKTON, CA 95210-4498
(209) 478-1090
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSB 31866
CA
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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