Individual
GENE MATTHEW NINOBLA FLORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
442 E HAMPTON ST, STOCKTON, CA 95204-5519
(209) 466-0456
Mailing address
1759 MINI DR, VALLEJO, CA 94589-1517
(707) 567-9878
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA6934
CA
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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