Individual
MRS. MARYA W OAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1508 WEST LN, STOCKTON, CA 95205-3340
(209) 948-2886
(209) 948-2831
Mailing address
420 W ACACIA ST, STE 1, STOCKTON, CA 95203-2441
(209) 948-1583
(209) 948-3564
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
NP15701
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ06588Z
INDIVIDUAL MEDICARE PTAN
CA
01
—
ZZZ25352Z
GROUP PTAN
CA
Enumeration date
01/26/2006
Last updated
03/16/2016
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