MEDICARE: LANI BAIN STONER LMFT

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	174400000X	Specialist	MFT 30965	CA

General Provider Information

NPI Number	:	1811067713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANI BAIN STONER LMFT

Provider Business Mailing Address
First Line	:	4555 N PERSHING AVE
Second Line	:	#33-193
City	:	STOCKTON
State	:	CA
Zip	:	95207-6740
Country	:	US
Telephone Number	:	209-477-9009
Fax Number	:	209-957-2587

Provider Business Practice Location Address
First Line	:	2431 W MARCH LN
Second Line	:	#210
City	:	STOCKTON
State	:	CA
Zip	:	95207-8211
Country	:	US
Telephone Number	:	209-477-9009
Fax Number	:

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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Directions to “ LANI BAIN STONER LMFT” Practice Location

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