Healthcare Provider Details

I. General information

NPI: 1770495376
Provider Name (Legal Business Name): TARINA OF STOCKTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6037 N PERSHING AVE
STOCKTON CA
95207-4158
US

IV. Provider business mailing address

970 RESERVE DR STE 100
ROSEVILLE CA
95678-1377
US

V. Phone/Fax

Practice location:
  • Phone: 209-951-2030
  • Fax: 209-951-3036
Mailing address:
  • Phone: 916-759-1969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER J COULTER
Title or Position: PRINCIPAL
Credential:
Phone: 916-759-1969