Individual
CHRISTINA TY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN
Contact information
Practice address
3108 BRYANT DR, STOCKTON, CA 95212-3419
(209) 915-4848
Mailing address
3108 BRYANT DR, STOCKTON, CA 95212-3419
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
828711
CA
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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