Individual
EDITH REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4815 PALMER AVE, STOCKTON, CA 95215-1824
(209) 430-1179
Mailing address
4815 PALMER AVE, STOCKTON, CA 95215-1824
(209) 430-1179
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95011503
CA
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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