Mucker, Latisha Rose

Mucker, Latisha Rose is an individual health care provider with primary practice located at 620 N Aurora St , Stockton CA 95202-2343. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Day Training/Habilitation Specialist, Other Service Providers / Peer Specialist. Nursing Service Related Providers / Day Training/Habilitation Specialist is her primary health care specialty. Mucker, Latisha Rose can be contacted via phone (209) 468-8786.

Contact Information

Primary practice address
620 N Aurora St Stockton CA 95202-2343
Phone: (209) 468-8786
Fax: (209) 468-9611
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Day Training/Habilitation Specialist 373H00000X
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1245733203
LBN Legal business name Mucker, Latisha Rose
Credentials PEER RECOVERY COACH
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2018
Last updated Jun 19th, 2026 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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