Individual
KERRY WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC
Contact information
Practice address
1414 N CALIFORNIA ST, STOCKTON, CA 95202-1515
(209) 468-2385
Mailing address
1414 N CALIFORNIA ST FL 2, STOCKTON, CA 95202-1515
(209) 468-2385
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
559310
CA
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
559310
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
559310
REGISTERED NURSE
CA
Enumeration date
10/26/2022
Last updated
10/27/2022
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