PUBLIC HEALTH LAB, SAN JOAQUIN CO PUB HLTH SVS (NPI# 1114060522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114060522 |
| Entity Type | Organization |
| Organization Name | PUBLIC HEALTH LAB, SAN JOAQUIN CO PUB HLTH SVS |
| Practice Address |
1601 E Hazelton Ave Stockton CA 95205-6229 |
| Mailing Address |
Po Box 2009 Stockton CA 95201-2009 |
| Practice Telephone | 2094683413 |
| Practice Fax Number | 2094682072 |
| Mailing Telephone | 2094683413 |
| Mailing Fax Number | 2094682072 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. WILLIAM MITCHELL (DIRECTOR PUBLIC HEALTH SERVICES) |
| Authorized Official Telephone | 2094683413 |
| Authorized Official Credential | MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Street Address |
1601 E HAZELTON AVE |
| City | STOCKTON |
| State | CA |
| Zip Code | 95205-6229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144231739 | Karen L. Furst | Preventive Medicine | 1601 E Hazelton Ave, Stockton, CA 95205-6229 | 2006-08-10 |
| 1679023980 | County of San Joaquin | Clinic/Center | 1601 E Hazelton Ave, Stockton, CA 95205-6229 | 2016-10-11 |
| 1730532524 | Surbhi Jayant | Registered Nurse | 1601 E Hazelton Ave, Stockton, CA 95205-6229 | 2016-07-18 |
| 1366800245 | Jajin Koo | Registered Nurse | 1601 E Hazelton Ave, Stockton, CA 95205-6229 | 2016-02-05 |
| 1730586793 | Cheryl Noel Jones | Registered Nurse | 1601 E Hazelton Ave, Stockton, CA 95205-6229 | 2014-11-19 |
| 1669875571 | Wendy Buthenuth | Registered Nurse | 1601 E Hazelton Ave, Stockton, CA 95205-6229 | 2014-10-06 |
| 1659685477 | Betty Dennison | Registered Nurse | 1601 E Hazelton Ave, Stockton, CA 95205-6229 | 2010-08-04 |
| 1639483464 | Pamela Kochi-lam | Registered Nurse | 1601 E Hazelton Ave, Stockton, CA 95205-6229 | 2010-08-04 |
| 1437382272 | Marsha Lou Chellsen | Registered Nurse | 1601 E Hazelton Ave, Stockton, CA 95205-6229 | 2009-08-27 |
| 1346401080 | Julie Kay Vaishampayan | Internal Medicine | 1601 E Hazelton Ave, Stockton, CA 95205-6229 | 2008-06-24 |
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|---|---|---|---|---|
| 1841801081 | Telegenx, LLC | Durable Medical Equipment & Medical Supplies | 127 S Locust St, Stockton, CA 95205 | 2020-08-12 |
| 1487130191 | Rassiwala Dental Corporation | Dentist | 2043 E Fremont St Ste 8, Stockton, CA 95205 | 2018-07-16 |
| 1518464692 | Szarisse Fernandez | Pharmacist | 2040 E. Mariposa Rd., Stockton, CA 95205 | 2018-04-06 |
| 1467820019 | San Joaquin County Bhs | Non-emergency Medical Transport (VAN) | 1149 N. El Dorado St., Stockton, CA 95205 | 2015-09-11 |
| 1346617651 | Kevin G.y. Tom | Pharmacist | 1528 Fremont St, Stockton, CA 95205 | 2015-08-24 |
| 1578749149 | Peebles Family Care Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 404 North Broadway Ave, Stockton, CA 95205 | 2008-01-14 |
| 1780874149 | Mv Transportation | Non-emergency Medical Transport (VAN) | 1250 South Wilson Way, Mv Transportation Ste #a1, Stockton, CA 95205 | 2007-07-31 |
| 1467513549 | Stockton Pharmacy | Pharmacy | 3330 E Main St, Stockton, CA 95205 | 2006-12-13 |
| 1174155170 | Phillip Brandon Long | Pharmacist | 2040 E Mariposa Rd, Stockton, CA 95205 | 2020-02-07 |
| 1558904136 | Angela Moss Burns | Counselor | 430 N Pilgrim St, Stockton, CA 95205 | 2019-10-25 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 1649315821 | Unilab Corporation | Clinical Medical Laboratory | 2291 W March Lane, Suite 145 F, Stockton, CA 95207-6652 | 2007-02-21 |
| 1205213196 | Stockton Pathology Medical Group | Clinical Medical Laboratory | 2131 N California St, Stockton, CA 95204-6030 | 2015-04-30 |
| 1972874501 | West Coast Diagnostics LLC | Clinical Medical Laboratory | 8978 Bainbridge Pl, Stockton, CA 95209-4807 | 2012-01-12 |
| 1730324518 | Stockton Pain Medical Center | Clinical Medical Laboratory | 3031 W March Lane, #101, Stockton, CA 95219 | 2008-12-09 |
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| 1366049447 | Sts Lab 1 LLC | Clinical Medical Laboratory | 2302 Trade Zone Blvd Rm 100, San Jose, CA 95131-1819 | 2020-10-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.