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1902168412
KIMBERLY LATOYA GANNER
STOCKTON, CA
NPI
1902168412
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
167G00000X Licensed Psychiatric Technician
(Licence: CA 36498)
Enumeration Date
2012-06-11
Last Update Date
2012-06-11
Business Address
-- KIMBERLY LATOYA GANNER
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone number: 209-468-8700
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Mailing Address
-- KIMBERLY LATOYA GANNER
3222 JONATHEN ST
STOCKTON, CA 95206-5916
Phone number: 209-817-7301
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