Individual
CHANRITH OU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-9373
Mailing address
4031 MADDIE CIR, STOCKTON, CA 95209-3767
(209) 566-3300
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/03/2025
Last updated
06/02/2025
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