Individual
JESSICA NICOLE SERRANO I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-0125
Mailing address
228 S ROSE ST APT 7, LODI, CA 95240-3474
(209) 570-1861
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41033
CA
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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