Individual
MS. BOBBIE JEAN KENOLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-3760
Mailing address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-3760
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/13/2012
Last updated
03/02/2017
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