Individual
CLAUDIA ENITH VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1149 N EL DORADO ST, STOCKTON, CA 95202-1305
(209) 468-2335
Mailing address
1149 N EL DORADO ST, STOCKTON, CA 95202-1305
(209) 468-2335
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D56247103
DRIVER LICENSE
CA
Enumeration date
10/06/2008
Last updated
10/06/2008
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