Individual
MR. JAMES DEAN STALIANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP
Contact information
Practice address
1540 FLORIDA AVE, MODESTO, CA 95350-4430
(866) 682-4842
Mailing address
737 W CHILDS AVE, MERCED, CA 95341-6805
(866) 682-4842
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
452145
CA
363LA2200X
Adult Health Nurse Practitioner
95010123
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
95010123
CA
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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