| S.j.c. Mhsa Cys Foster Youth Fsp Intake | |
|
333 E Washington St Stockton CA 95202-3200 | |
| (209) 468-8750 | |
| Not Available |
| Full Name | S.j.c. Mhsa Cys Foster Youth Fsp Intake |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 333 E Washington St, Stockton, California |
| Authorized Official Name and Position | Genevieve Valentine (DIRECTOR, BEHAVIORAL HEALTH) |
| Authorized Official Contact | 2094688887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| S.j.c. Mhsa Cys Foster Youth Fsp Intake 333 E Washington St Stockton CA 95202-3200 Ph: (209) 468-8750 | S.j.c. Mhsa Cys Foster Youth Fsp Intake 333 E Washington St Stockton CA 95202-3200 Ph: (209) 468-8750 |
| NPI Number | 1043920978 |
|---|---|
| Provider Enumeration Date | 12/01/2022 |
| Last Update Date | 07/13/2023 |
| Certification Date | 07/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043920978 | NPI | - | NPPES |
| 9096 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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