Individual
STEVIE TAKATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1560 N MINNEWAWA AVE, CLOVIS, CA 93619-7698
(559) 327-3279
Mailing address
3330 HERMOSA AVE, CLOVIS, CA 93619-7284
(808) 345-4602
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-330
HI
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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