SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES (NPI# 1598284366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598284366 |
| Entity Type | Organization |
| Organization Name | SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES |
| Other Organization Name | WPC-BEHAVIORAL HEALTH SERVICES INTEGRATION TEAM |
| Practice Address |
1212 N California St Stockton CA 95202-1552 |
| Practice Telephone | (209) 468-8778 |
| Practice Fax Number | 2094683486 |
| Mailing Telephone | 2094688778 |
| Mailing Fax Number | 2094683486 |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2017-09-13 |
| Authorized Official Name | FRANCES HUTCHINS (INTERIM DIRECTOR BEHAVIORAL HEALTH) |
| Authorized Official Telephone | 2094688750 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 39B9 | 05 |
| Other Name | Type Code |
|---|---|
| WPC-Behavioral Health Services Integration Team | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932664620 | San Joaquin County Behavioral Health Services | Community/Behavioral Health | 1212 N. Califorian St, Stockton, CA 95202 | 2019-02-06 |
| 1215214069 | San Joaquin County Behavioral Health Services | Clinic/Center | 24 S Hunter St, Stockton, CA 95202-3231 | 2011-11-08 |
| 1609085984 | San Joaquin County Behavioral Health Services | Clinic/Center | 6776 Alexandria Pl, Stockton, CA 95207-3407 | 2007-05-22 |
| 1548478142 | San Joaquin County Behavioral Health Services | Clinic/Center | 6861 Mary Graham Lane, French Camp, CA 95231 | 2007-05-18 |
| 1376750232 | San Joaquin County Behavioral Health Services | Clinic/Center | 535 W Mathews Rd, French Camp, CA 95231-9757 | 2007-05-17 |
| 1710193537 | San Joaquin County Behavioral Health Services | Clinic/Center | 1149 N El Dorado St, Stockton, CA 95202-1305 | 2007-05-16 |
| 1306051370 | San Joaquin County Behavioral Health Services | Clinic/Center | 220 W 11th St, Tracy, CA 95376-3944 | 2007-05-13 |
| 1497968184 | San Joaquin County Behavioral Health Services | Substance Abuse Rehabilitation Facility | 500 W. Hospital Road, French Camp, CA 95231 | 2007-05-08 |
| 1598232456 | San Joaquin County Behavioral Health Services | Clinic/Center | 1212 N California St, Stockton, CA 95202-1552 | 2018-10-30 |
| 1740711902 | San Joaquin County Behavioral Health Services | Community/Behavioral Health | 1212 N California St, Stockton, CA 95202-1552 | 2017-03-21 |
| Street Address |
1212 N CALIFORNIA ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95202-1552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972592939 | Jin R. Soofi | Psychiatry & Neurology | 1212 N California St, Stockton, CA 95202-1552 | 2005-10-20 |
| 1750981437 | Matthew Robin Devera | Licensed Psychiatric Technician | 1212 N California St, Stockton, CA 95202-1552 | 2020-10-30 |
| 1609475581 | Bailey T Manego | Recreational Therapist Assistant | 1212 N California St, Stockton, CA 95202-1552 | 2020-10-21 |
| 1265039226 | Zachary Hensley | Marriage & Family Therapist | 1212 N California St, Stockton, CA 95202-1552 | 2020-10-02 |
| 1508477662 | Danielle Wiseman | Counselor | 1212 N California St, Stockton, CA 95202-1552 | 2020-08-12 |
| 1073121414 | Criselle Jane Carillo Sumampong | Licensed Psychiatric Technician | 1212 N California St, Stockton, CA 95202-1552 | 2020-07-22 |
| 1477161396 | Meliza Ann Agpaoa Ruiz | Licensed Psychiatric Technician | 1212 N California St, Stockton, CA 95202-1552 | 2020-07-16 |
| 1124646815 | Maria Truong | Counselor | 1212 N California St, Stockton, CA 95202-1552 | 2020-07-08 |
| 1871110437 | Victoria Lynn Phillips | Social Worker | 1212 N California St, Stockton, CA 95202-1552 | 2020-06-30 |
| 1730702119 | Jennifer J Salon | Licensed Psychiatric Technician | 1212 N California St, Stockton, CA 95202-1552 | 2020-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336774678 | Lecletus Griffin Jr. | Counselor | 1212 N. Califronia Street, Stockton, CA 95202 | 2020-03-06 |
| 1861035586 | Andrea Mn Perkins | Social Worker | Sjc Bhs Bacop, 1149 El Dorado Street, Stockton, CA 95202 | 2019-10-25 |
| 1932664620 | San Joaquin County Behavioral Health Services | Community/Behavioral Health | 1212 N. Califorian St, Stockton, CA 95202 | 2019-02-06 |
| 1730655895 | Jenaiah La'neise Sauceda | Social Worker | 343 E Main St Ste 918, Stockton, CA 95202 | 2018-10-16 |
| 1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
| 1912406976 | Janet Mendoza | Social Worker | 6 South Eldorado Street, Stockton, CA 95202 | 2018-02-06 |
| 1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
| 1124545355 | Suleyma Velesquez | Counselor | 445 N. San Joaquin St., Stockton, CA 95202 | 2017-08-28 |
| 1821513946 | Savoeun Phal | Counselor | 1212 N California St Ste A214, Stockton, CA 95202 | 2017-08-09 |
| 1861921272 | Mandeep K Minhas | Registered Nurse | 1212 California St, Stockton, CA 95202 | 2017-06-08 |
| Find all providers in zip 95202 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881241776 | Delta Center Family Therapy Inc | Clinic/Center | 343 E Main St Ste 701, Stockton, CA 95202-2977 | 2019-08-24 |
| 1790344539 | Telecare Corporation | Clinic/Center | 4545 Georgetown Pl Ste D and E28, Stockton, CA 95207-6229 | 2019-06-06 |
| 1982071502 | Telecare Corporation | Clinic/Center | 4545 Georgetown Place, Suite A3, Stockton, CA 95207-6228 | 2015-08-31 |
| 1215214069 | San Joaquin County Behavioral Health Services | Clinic/Center | 24 S Hunter St, Stockton, CA 95202-3231 | 2011-11-08 |
| 1740584218 | Nathaniel Scott | Clinic/Center | 234 E Fremont St, Stockton, CA 95202-2016 | 2010-12-27 |
| 1669099743 | Telecare Corporation | Clinic/Center | 4545 Georgetown Pl Ste D and E28, Stockton, CA 95207-6229 | 2020-07-06 |
| 1730706813 | Telecare Corporation | Clinic/Center | 4545 Georgetown Pl Ste A3, Stockton, CA 95207-6228 | 2020-07-06 |
| 1518526359 | Telecare Corporation | Clinic/Center | 4545 Georgetown Pl, Suite D and E-28, Stockton, CA 95207-6229 | 2019-06-06 |
| 1043781354 | San Joaquin County Behavioral Heatlh Services | Clinic/Center | 1212 N California St, Stockton, CA 95202-1552 | 2018-12-12 |
| 1598232456 | San Joaquin County Behavioral Health Services | Clinic/Center | 1212 N California St, Stockton, CA 95202-1552 | 2018-10-30 |
| Find all providers in STOCKTON | ||||
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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.