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SAN JOAQUIN KIDNEY CLINIC, INC
NPI 1407897358
Specialist in Stockton, CA

Active since June 10, 2006CLIA 05D1010358 · Waiver
1801 E MARCH LN # B-265, STOCKTON, CA 95210(209) 546-1868(209) 461-6505 Get Directions Write a Review

NPPES record last updated: January 29, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About San Joaquin Kidney Clinic, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAN JOAQUIN KIDNEY CLINIC, INC (NPI 1407897358) is a healthcare organization registered as a specialist in Stockton, California and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through March 10, 2027, maintains 2 additional practice locations, and lists P. B. Sagireddy, Owner, as its authorized official.

NPPES Registry Identity

NPI1407897358
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSAN JOAQUIN KIDNEY CLINIC, INC
Location Address1801 E MARCH LN # B-265Stockton, CA 95210-6629
Mailing Address1801 E March Ln # B-265Stockton, CA 95210-6629 · (209) 546-1868 · Fax (209) 461-6505
Phone(209) 546-1868
Fax(209) 461-6505
Organization SubpartNo
Authorized OfficialP. B. SagireddyOwner · (209) 546-1868
Enumeration DateJune 10, 2006
Last NPPES UpdateJanuary 29, 2025
NPPES CertifiedJanuary 29, 2025
✔ NPI 1407897358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · A73135
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1801 E MARCH LN # B-265, Stockton, CA 95210
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Other Names 1

Doing Business AsSan Joaquin Kidney Clinic, Inc

Secondary Practice Locations 2

Location 1801 S Ham Ln Ste JLodi, CA 95242-7502 · Phone (209) 546-1868 · Fax (209) 461-6505
Location 21530 Bessie Ave Ste 107Tracy, CA 95376-3080 · Phone (209) 546-1868 · Fax (209) 461-6505

Other Identifiers 2

OtherDA0971CA · Railroad Medicare
Medicaid00A731351CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1010358

San Joaquin Kidney Clinic Inc P B Sagireddy MD · Stockton, CA
Active · expires Mar 10, 2027
CLIA Number05D1010358
Laboratory TypePhysician Office
Certificate Effective DateMarch 11, 2025
Certificate Expiration DateMarch 10, 2027
Laboratory DirectorP B. Sagireddy MD
Laboratory Phone(209) 546-1868
Laboratory LocationSan Joaquin Kidney Clinic Inc P B Sagireddy MD1801 E March Ln Suite B265, Stockton, CA 95210
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is San Joaquin Kidney Clinic, Inc's NPI number?

The NPI number for San Joaquin Kidney Clinic, Inc is 1407897358. It was assigned to this organization in the NPPES registry on June 10, 2006.

Where is San Joaquin Kidney Clinic, Inc located?

San Joaquin Kidney Clinic, Inc is located at 1801 E March Ln # B-265, Stockton, CA 95210. The listed phone number is (209) 546-1868.

What is San Joaquin Kidney Clinic, Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does San Joaquin Kidney Clinic, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1010358) is associated with this NPI, valid through March 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for San Joaquin Kidney Clinic, Inc was last updated on January 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.