Individual
TARA JANE IRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
975 N D ST, STOCKTON, CA 95205-4367
(209) 470-3836
Mailing address
4652 SPYGLASS DR, STOCKTON, CA 95219-1927
(209) 609-6430
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
632072
CA
Other
Enumeration date
05/13/2022
Last updated
05/13/2022
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