Individual
MRS. KIMBERLY NINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1149 N EL DORADO ST, STOCKTON, CA 95202-1305
(209) 468-2337
Mailing address
1149 N EL DORADO ST, STOCKTON, CA 95202-1305
(209) 468-2337
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
11/07/2014
Last updated
11/07/2014
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