Individual
HARRIET K WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3854 TRIESTE CIR, STOCKTON, CA 95205-9214
(510) 866-3893
Mailing address
3854 TRIESTE CIR, STOCKTON, CA 95205-9214
(510) 866-3893
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2100139963
CA
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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