Individual
ANTOINE MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
503 S PERSHING AVE, STOCKTON, CA 95203-3236
(209) 810-5864
Mailing address
503 S PERSHING AVE, STOCKTON, CA 95203-3236
(209) 810-5864
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
02/01/2012
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