Healthcare Provider Details

I. General information

NPI: 1972874501
Provider Name (Legal Business Name): WEST COAST DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2012
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8978 BAINBRIDGE PL
STOCKTON CA
95209-4807
US

IV. Provider business mailing address

8978 BAINBRIDGE PL
STOCKTON CA
95209-4807
US

V. Phone/Fax

Practice location:
  • Phone: 209-406-4142
  • Fax:
Mailing address:
  • Phone: 209-406-4142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number109903
License Number StateCA

VIII. Authorized Official

Name: VIRGINIA A KRAPF
Title or Position: OWNER
Credential: RCP
Phone: 209-406-4142