person
Octavia Ivy
Student in an Organized Health Care Education/Training Program in Stockton, California
NPI 1326462789

Octavia Ivy is a Student in an Organized Health Care Education/Training Program based in Stockton, CA. Octavia Ivy practices in Stockton, CA. The NPI Number for Octavia Ivy is 1326462789 and holds a License No. (California).

The current practice location address for Octavia Ivy is 5405 N Pershing Ave, Stockton, CA and can be reached out via phone at 209-476-1959.

Location: 5405 N Pershing Ave, Stockton, CA, 95207-5451
person
Provider Profile Details
NPI Number
1326462789
Provider Name
Octavia Ivy
Credential
Provider Entity Type
Individual
Gender
Female
Address
5405 N Pershing Ave, Stockton, CA, 95207-5451
Phone Number
209-476-1959
Fax Number
Provider Enumeration Date
02/05/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
5405 N Pershing Ave
City
State
Zip
95207-5451
Phone Number
209-476-1959
Fax Number
person
Provider Business Mailing Address Details
Address
5405 N Pershing Ave
City
State
Zip
95207-5451
Phone Number
209-476-1959
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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