Individual
ALICE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1305 TOMMYDON ST, STOCKTON, CA 95210-3364
(209) 476-5200
Mailing address
3749 WHISPERING CREEK CIR, STOCKTON, CA 95219-2329
(209) 952-5156
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
L8157
TX
Other
Enumeration date
07/28/2005
Last updated
12/27/2021
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