| Victor Community Support Services, Stockton | |
|
2495 W March Ln Suite 125 Stockton CA 95207-8251 | |
| (209) 465-1080 | |
| Not Available |
| Full Name | Victor Community Support Services, Stockton |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 2495 W March Ln, Stockton, California |
| Authorized Official Name and Position | Angie R Wiechert (MANAGER OF FINANCIAL PLANNING) |
| Authorized Official Contact | 5302301210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victor Community Support Services, Stockton 1360 E Lassen Ave Chico CA 95973-7823 Ph: (530) 893-0758 | Victor Community Support Services, Stockton 2495 W March Ln Suite 125 Stockton CA 95207-8251 Ph: (209) 465-1080 |
| NPI Number | 1932251980 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 08/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932251980 | NPI | - | NPPES |
| 01042 | Other | CA | LEGAL ENTITY # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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