MHSA-LA FAMILIA FSP (SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES) NPI 1003002353
Clinic/Center (Mental Health (Including Community Mental Health Center)) in Stockton, CA
About MHSA-LA FAMILIA FSP (SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES)
Mhsa-la Familia Fsp (san Joaquin County Behavioral Health Services) is a provider established in Stockton, California specializing in clinic/center (mental health (including community mental health center)) . The NPI number of Mhsa-la Familia Fsp (san Joaquin County Behavioral Health Services) is 1003002353 and was assigned on September 2007. The practitioner's primary taxonomy code is 261QM0801X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Mhsa-la Familia Fsp. The authorized official of this NPI record is Tony Vartan Lcsw (Director Behavioral Health Services)
NPI | 1003002353 |
Provider Name | MHSA-LA FAMILIA FSP (SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES) |
Provider Location Address | 1212 N CALIFORNIA ST STOCKTON, CA 95202 |
Provider Mailing Address | 1212 N CALIFORNIA ST STOCKTON, CA 95202 |
NPI Entity Type | Organization |
Is Sole Proprietor? | N/A |
Is Organization Subpart? | No |
Other Organization Name | MHSA-LA FAMILIA FSP |
Other Name Type | Doing Business As (3) |
Enumeration Date | 09-20-2007 |
Last Update Date | 03-10-2020 |
Primary Taxonomy
Taxonomy Code | 261QM0801X |
Classification | Clinic/Center |
Type | Ambulatory Health Care Facilities |
Specialization | Mental Health (Including Community Mental Health Center) |
License State | CA |
Business Address
MHSA-LA FAMILIA FSP
1212 N CALIFORNIA ST
STOCKTON, CA
ZIP 95202
Phone: (209) 468-8778
Fax: (209) 462-2399
Mailing Address
MHSA-LA FAMILIA FSP
1212 N CALIFORNIA ST
STOCKTON, CA
ZIP 95202
Phone: (209) 468-8778
Fax: (209) 468-2399
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State |
---|---|---|
9092 | MEDICAID (05) | CA |
Other Providers at the same location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1033235304 | MS. DEBRA L. GRINSTEAD R. N. Individual | Registered Nurse | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8843 |
1114044799 | MR. PAUL DAVID WALLACE Individual | Licensed Psychiatric Technician | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-3760 |
1124143474 | MS. SHIRLEY ANN HOLLOWELL R.N. Individual | Registered Nurse (Psychiatric/Mental Health, Adult) | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 953-1033 |
1184732117 | DR. ADEGOKE ADEYEMO M.D. Individual | Psychiatry & Neurology (Psychiatry) | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8491 |
1225152424 | MRS. LINDA RAMSAY OCLARAY MASTER OF ARTS Individual | Marriage & Family Therapist | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 953-7463 |
1225156599 | MRS. GABRIELA GARCIA ELIZALDI MSW, ASW Individual | Social Worker | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-2385 |
1235256207 | MR. JOHN D SCHAEFFER MFT Individual | Marriage & Family Therapist | 1212 N CALIFORNIA ST INPATIENT STOCKTON, CA 95202 (209) 468-8082 |
1255459061 | MARIA ELIZABETH ARROYO R N Individual | Registered Nurse (Psychiatric/Mental Health, Adult) | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8660 |
1306960331 | MRS. ANNALIZA LAGRUTTA MA Individual | Marriage & Family Therapist | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8644 |
1366560112 | ROBERT S GRAFF M.D. Individual | Psychiatry & Neurology (Psychiatry) | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-6937 |
1417074071 | MS. GLORIA ANN GREENING PSYCHIATRIC TECHNICI Individual | Licensed Psychiatric Technician | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8660 |
1417074386 | MR. HOWARD LAWRENCE LEWIS L.P.T. Individual | Licensed Psychiatric Technician | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8880 |
1477687077 | MR. EDWARD WILLIAM OLPIN ACSW Individual | Social Worker (Clinical) | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8880 |
1639294341 | PROF. REMEDIOS AGUADA WALLACE Individual | Licensed Psychiatric Technician | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8842 |
1649396045 | MRS. CYNTHIA L MORISHIGE LCSW Individual | Social Worker (Clinical) | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8643 |
1699890921 | MR. RICHARD ANTHONY BENITEZ MHC I Individual | Marriage & Family Therapist | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8700 |
1770601304 | MR. CHRISTOPHER EGONIO Individual | Case Manager/Care Coordinator | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-3760 |
1780709014 | MR. GARY A. GRAY PT Individual | Counselor (Mental Health) | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8700 |
1811014780 | MS. SUSAN MARIE GRUBER MSW Individual | Social Worker | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-3760 |
1932218849 | MALY XIONG MFT INTERN Individual | Marriage & Family Therapist | 1212 N CALIFORNIA ST STOCKTON, CA 95202 (209) 468-8082 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.