Individual
BRENDA ELLEN ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1604 DOUGLAS RD, STOCKTON, CA 95207-4115
(209) 915-6223
Mailing address
1604 DOUGLAS RD, STOCKTON, CA 95207-4115
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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