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KHAMEELAH DESTINY BONNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPT

Contact information

Practice address
1414 N CALIFORNIA ST, STOCKTON, CA 95202-1515
(209) 468-6820
Mailing address
1414 N CALIFORNIA ST, STOCKTON, CA 95202-1515
(209) 468-6820

Taxonomy

Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
43121
CA

Other

Enumeration date
02/04/2026
Last updated
02/04/2026
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