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General NPI Number Information
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NPI Number | 1770495376
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Entity Type | Organization
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Legal Business Name | TARINA OF STOCKTON LLC
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 6037 N PERSHING AVE
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City | STOCKTON
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State | CA
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Zip | 95207-4158
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Country | US
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Telephone | 209-951-2030
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Fax | 209-951-3036
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Provider Business Mailing Address
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Address Line | 970 RESERVE DR STE 100
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City | ROSEVILLE
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State | CA
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Zip | 95678-1377
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Country | US
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Telephone | 916-759-1969
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL
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Name | CHRISTOPHER J COULTER
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Credential |
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Telephone | 916-759-1969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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