| NPI | 1285247486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIE STORMES Managing Officer 209-327-3366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2022-05-03 |