Most Relevant Information
Provider Data
| NPI Number: | 1003039330 |
| Provider Name: | DOLORIS MOODY |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/11/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1212 N CALIFORNIA ST
STOCKTON
CA
952021552
Practice Location Phone/Fax
| Phone: | 2094688660 |
| Fax: |
Provider Mailing Location
412 YOSEMITE DR
TRACY
CA
953765103
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |