Individual
MARLINE SHARON KOTTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8661
Mailing address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8661
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
198957
CA
164X00000X
Licensed Vocational Nurse
VN198957
CA
Other
Enumeration date
05/31/2017
Last updated
01/16/2024
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