Individual
LOIS CARTER-SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4545 GEORGETOWN PL STE A3, STOCKTON, CA 95207-6228
(209) 479-5429
Mailing address
4545 GEORGETOWN PL STE A3, STOCKTON, CA 95207-6228
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-VNMTRX
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YA0400X
BEHAVIORAL HEALTH AND SOCIAL SERVICES PROVIDER
CA
Enumeration date
09/06/2013
Last updated
10/02/2023
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