MEDICARE: ARACELI ANDRADE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1205566965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARACELI ANDRADE

Provider Business Mailing Address
First Line	:	7210 MURRAY DR
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95210-3339
Country	:	US
Telephone Number	:	209-414-9260
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 N STANISLAUS ST
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95202-2949
Country	:	US
Telephone Number	:	209-414-9260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2022
Last Update Date	:	06/15/2022

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Directions to “ ARACELI ANDRADE ” Practice Location

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