MEDICARE: BEVERLY LUANNE STOCKS

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1588127161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY LUANNE STOCKS

Provider Business Mailing Address
First Line	:	264 CLOVIS AVE STE 205
Second Line	:
City	:	CLOVIS
State	:	CA
Zip	:	93612-1115
Country	:	US
Telephone Number	:	559-343-1999
Fax Number	:

Provider Business Practice Location Address
First Line	:	264 CLOVIS AVE STE 205
Second Line	:
City	:	CLOVIS
State	:	CA
Zip	:	93612-1115
Country	:	US
Telephone Number	:	559-343-1999
Fax Number	:

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

Provider Enumeration Date	:	04/10/2019
Last Update Date	:	02/11/2026

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Directions to “ BEVERLY LUANNE STOCKS ” Practice Location

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