Individual
ISABELLA XILONEN MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8626 LOWER SAC RD, STOCKTON, CA 95210-1835
(209) 478-2487
Mailing address
6493 BROOK HOLLOW CIR, STOCKTON, CA 95219-2436
(209) 938-9234
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
41854
CA
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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