Provider First Line Business Practice Location Address:
DEPARTMENT OF PSYCHOLOGY
Provider Second Line Business Practice Location Address:
3601 PACIFIC AVE.
Provider Business Practice Location Address City Name:
STOCKTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95211-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
209-946-7320
Provider Business Practice Location Address Fax Number:
209-946-2454
Provider Enumeration Date:
02/20/2009