Individual
WENDY BUTHENUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 E HAZELTON AVE, STOCKTON, CA 95205-6229
(209) 468-3874
Mailing address
3581 W BENJAMIN HOLT DR, STOCKTON, CA 95219-3464
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
377440
CA
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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