| Sjc-mhs-tygr Program | |
|
1212 N California St Stockton CA 95202-1552 | |
| (209) 468-8778 | |
| (209) 468-2399 |
| Full Name | Sjc-mhs-tygr Program |
|---|---|
| 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 OF BEHAVIORAL HEALTH SERV) |
| Authorized Official Contact | 2094688887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sjc-mhs-tygr Program 1212 N California St Stockton CA 95202-1552 Ph: (209) 468-8778 | Sjc-mhs-tygr Program 1212 N California St Stockton CA 95202-1552 Ph: (209) 468-8778 |
| NPI Number | 1821367210 |
|---|---|
| Provider Enumeration Date | 12/14/2011 |
| Last Update Date | 11/21/2023 |
| Certification Date | 11/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821367210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (California) | Primary |
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