Individual
ENRIQUE BECERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
3601 PACIFIC AVE, STOCKTON, CA 95211-0110
(209) 946-2588
Mailing address
3300 RENWICK AVE UNIT 2035, ELK GROVE, CA 95758-7495
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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