Provider Demographics
NPI:1508192717
Name:STOCKTON, NANCY J (CMT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:STOCKTON
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 SPRINGOAK WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-2037
Mailing Address - Country:US
Mailing Address - Phone:209-639-3211
Mailing Address - Fax:209-951-0623
Practice Address - Street 1:8700 THORNTON RD STE B
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-1815
Practice Address - Country:US
Practice Address - Phone:209-639-3211
Practice Address - Fax:209-951-0623
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAP08215175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath