Individual
KRISTY CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
442 E HAMPTON ST, STOCKTON, CA 95204-5519
(209) 466-0456
Mailing address
9317 MAPLEVIEW WAY, ELK GROVE, CA 95758-5010
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3524
CA
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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