Individual
CALVIN RAY BENNET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SUDRC
Contact information
Practice address
1981 CHEROKEE RD, STOCKTON, CA 95205-2720
(209) 870-6500
Mailing address
1981 CHEROKEE RD, STOCKTON, CA 95205-2720
(209) 870-6500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
39007BN
CA
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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