Individual
RENAE JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-2343
Mailing address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-2343
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-PWOO12
CA
Other
Enumeration date
08/19/2014
Last updated
11/06/2024
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