Individual
JONATHAN D FLORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-3760
Mailing address
2189 AZEVEDO AVE, MANTECA, CA 95337-8975
(209) 624-6881
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
42446
CA
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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