Healthcare Provider Details

I. General information

NPI: 1619884277
Provider Name (Legal Business Name): LAQUISHA SWANY'E BEST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2522 GRAND CANAL BLVD STE 8
STOCKTON CA
95207-8213
US

IV. Provider business mailing address

1630 BONDY LN
TRACY CA
95376-3224
US

V. Phone/Fax

Practice location:
  • Phone: 209-948-4200
  • Fax:
Mailing address:
  • Phone: 414-946-1022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: