Individual
ANNA MARIE PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 N EL DORADO ST, STOCKTON, CA 95202-1305
(209) 938-0228
(209) 938-0281
Mailing address
1111 N EL DORADO ST, STOCKTON, CA 95202-1305
(209) 938-0228
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6197
CA
261Q00000X
Clinic/Center
39-07
CA
Other
Enumeration date
12/21/2006
Last updated
12/22/2023
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