Graduated: 1996
Offers telehealth
NPI: 1619190501
Practice Locations (2)
COUNTY OF SAN JOAQUIN
1209 W TOKAY ST, SUITE 5
LODI, CA 952403845
2093312070
COUNTY OF SAN JOAQUIN
1212 N CALIFORNIA ST
STOCKTON, CA 952021552
2094688700
Source: CMS National Downloadable File, September 2026.