Individual
JOSE TIENDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,ATC,CES
Contact information
Practice address
530 W WILLOW ST, STOCKTON, CA 95203-1834
(209) 639-1408
Mailing address
530 W WILLOW ST, STOCKTON, CA 95203-1834
(209) 639-1408
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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