Individual
NOEL LENA MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2633 PACIFIC AVE, STOCKTON, CA 95204-4429
(209) 944-5530
Mailing address
1011 MIDDLEFIELD AVE, STOCKTON, CA 95204-6205
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA20592
CA
Other
Enumeration date
10/16/2009
Last updated
10/09/2012
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