| Telecare San Joaquin Connect I | |
|
4545 Georgetown Pl Ste D And E28 Stockton CA 95207-6229 | |
| (209) 269-5587 | |
| (209) 230-9798 |
| Full Name | Telecare San Joaquin Connect I |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4545 Georgetown Pl Ste D And E28, Stockton, California |
| Authorized Official Name and Position | Lorena Lopez (PROVIDER RELATIONS SUPERVISOR) |
| Authorized Official Contact | 5103377950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Telecare San Joaquin Connect I 1080 Marina Village Pkwy Ste 100 Alameda CA 94501-1078 Ph: (510) 337-7950 | Telecare San Joaquin Connect I 4545 Georgetown Pl Ste D And E28 Stockton CA 95207-6229 Ph: (209) 269-5587 |
| NPI Number | 1790344539 |
|---|---|
| Provider Enumeration Date | 06/06/2019 |
| Last Update Date | 03/09/2023 |
| Certification Date | 03/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790344539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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