Individual
FAVIAN DE JESUS ORDAZ TRUJILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ASW
Contact information
Practice address
7210 MURRAY DR, STOCKTON, CA 95210-3339
(209) 636-0718
Mailing address
7210 MURRAY DR, STOCKTON, CA 95210-3339
(209) 636-0178
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ASW120736
CA
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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