| Sjc-mhs Ffs-psychiatrists-manage Care | |
|
1212 N California St Stockton CA 95202-1552 | |
| (209) 468-8700 | |
| (209) 468-2399 |
| Full Name | Sjc-mhs Ffs-psychiatrists-manage Care |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1212 N California St, Stockton, California |
| Authorized Official Name and Position | Genevieve Valentine (DIRECTOR-BEHAVIORAL HEALTH SERVICES) |
| Authorized Official Contact | 2094688750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sjc-mhs Ffs-psychiatrists-manage Care 1212 N California St Stockton CA 95202-1552 Ph: (209) 468-8778 | Sjc-mhs Ffs-psychiatrists-manage Care 1212 N California St Stockton CA 95202-1552 Ph: (209) 468-8700 |
| NPI Number | 1518176478 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518176478 | NPI | - | NPPES |
| 9023 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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