MHSA-LA FAMILIA FSP (SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES) NPI 1003002353

Clinic/Center (Mental Health (Including Community Mental Health Center)) in Stockton, CA

Organization Clinic/Center Mental Health (Including Community Menta...

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 NameMHSA-LA FAMILIA FSP (SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES)
Provider Location Address1212 N CALIFORNIA ST STOCKTON, CA 95202
Provider Mailing Address1212 N CALIFORNIA ST STOCKTON, CA 95202
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameMHSA-LA FAMILIA FSP
Other Name TypeDoing Business As (3)
Enumeration Date09-20-2007
Last Update Date03-10-2020

Primary Taxonomy

Taxonomy Code261QM0801X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationMental Health (Including Community Mental Health Center)
License StateCA

Business Address

MHSA-LA FAMILIA FSP
1212 N CALIFORNIA ST
STOCKTON, CA
ZIP 95202
Phone: (209) 468-8778
Fax: (209) 462-2399

Get Directions

Mailing Address

MHSA-LA FAMILIA FSP
1212 N CALIFORNIA ST
STOCKTON, CA
ZIP 95202
Phone: (209) 468-8778
Fax: (209) 468-2399

Authorized Official

Authorized Official Name TONY VARTAN LCSW
Authorized Official TitleDIRECTOR BEHAVIORAL HEALTH SERVICES
Authorized Official Phone(209) 468-8700

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
9092MEDICAID (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
1033235304MS. DEBRA L. GRINSTEAD R. N.
Individual
Registered Nurse1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-8843
1114044799MR. PAUL DAVID WALLACE
Individual
Licensed Psychiatric Technician1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-3760
1124143474MS. SHIRLEY ANN HOLLOWELL R.N.
Individual
Registered Nurse (Psychiatric/Mental Health, Adult)1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 953-1033
1184732117DR. ADEGOKE ADEYEMO M.D.
Individual
Psychiatry & Neurology (Psychiatry)1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-8491
1225152424MRS. LINDA RAMSAY OCLARAY MASTER OF ARTS
Individual
Marriage & Family Therapist1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 953-7463
1225156599MRS. GABRIELA GARCIA ELIZALDI MSW, ASW
Individual
Social Worker1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-2385
1235256207MR. JOHN D SCHAEFFER MFT
Individual
Marriage & Family Therapist1212 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
1306960331MRS. ANNALIZA LAGRUTTA MA
Individual
Marriage & Family Therapist1212 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
1417074071MS. GLORIA ANN GREENING PSYCHIATRIC TECHNICI
Individual
Licensed Psychiatric Technician1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-8660
1417074386MR. HOWARD LAWRENCE LEWIS L.P.T.
Individual
Licensed Psychiatric Technician1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-8880
1477687077MR. EDWARD WILLIAM OLPIN ACSW
Individual
Social Worker (Clinical)1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-8880
1639294341PROF. REMEDIOS AGUADA WALLACE
Individual
Licensed Psychiatric Technician1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-8842
1649396045MRS. CYNTHIA L MORISHIGE LCSW
Individual
Social Worker (Clinical)1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-8643
1699890921MR. RICHARD ANTHONY BENITEZ MHC I
Individual
Marriage & Family Therapist1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-8700
1770601304MR. CHRISTOPHER EGONIO
Individual
Case Manager/Care Coordinator1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-3760
1780709014MR. GARY A. GRAY PT
Individual
Counselor (Mental Health)1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-8700
1811014780MS. SUSAN MARIE GRUBER MSW
Individual
Social Worker1212 N CALIFORNIA ST
STOCKTON, CA 95202
(209) 468-3760
1932218849 MALY XIONG MFT INTERN
Individual
Marriage & Family Therapist1212 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.