Most Relevant Information
Provider Data
| NPI Number: | 1003386442 |
| Provider Name: | KRYSTAL MADELINE AVILA |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/28/2018 |
| Last Updated: | 12/14/2023 |
Provider Practice Location
2495 W MARCH LN
STOCKTON
CA
952078251
Practice Location Phone/Fax
| Phone: | 2094651080 |
| Fax: |
Provider Mailing Location
2495 W MARCH LN
STOCKTON
CA
952078251
Provider Mailing Phone/Fax
| Phone: | 2096164176 |
| Fax: |