Provider Information for 1194881136
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PEGGY LINGARD LCSW
Other Names:Other Name:PEGGY SHIDELERSex: Female
NPI: 1194881136
Last Updated: 2022-01-11
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1194881136 | ||||||||||||||
| Enumeration Date | 2006-12-27 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 7373 WEST LN STOCKTON, CA 95210-3377 United States Phone: 855-268-4096 | Fax: | ||||||||||||||
| Primary Practice Address | 1305 TOMMYDON ST STOCKTON, CA 95210-3364 United States Phone: 855-268-4096 | Fax: | ||||||||||||||
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