Individual
MRS. CYNTHIA ELIZABETH POULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8488
Mailing address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8488
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
315076
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
315076
REGISTERED NURSE
CA
01
—
32888
PUBLIC HEALTH NURSE
CA
Enumeration date
02/23/2011
Last updated
02/23/2011
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