Individual
MRS. HYMAVATHI DEVI KUNAMNENI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
1805 N CALIFORNIA ST STE 202, STOCKTON, CA 95204-6032
(209) 469-3690
(209) 467-1502
Mailing address
1805 N CALIFORNIA ST STE 202, STOCKTON, CA 95204-6032
(209) 469-3690
(209) 467-1502
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY17013
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
447320
VALUE OPTIONS
CA
01
—
A-05-688
ACCESS MANAGED CARE
CA
01
—
OPL170130
BLUE SHIELD
CA
01
—
P00089953
PALMETTO GBA
CA
05
—
PSY170130
—
CA
Enumeration date
08/14/2006
Last updated
07/08/2007
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