| Mhsa-la Familia Fsp | |
|
1212 N California St Stockton CA 95202-1552 | |
| (209) 468-8778 | |
| (209) 462-2399 |
| Full Name | Mhsa-la Familia Fsp |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1212 N California St, Stockton, California |
| Authorized Official Name and Position | Genevieve Valentine (DIRECTOR BEHAVIORAL HEALTH SERVICES) |
| Authorized Official Contact | 2094688887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mhsa-la Familia Fsp 1212 N California St Stockton CA 95202-1552 Ph: (209) 468-8778 | Mhsa-la Familia Fsp 1212 N California St Stockton CA 95202-1552 Ph: (209) 468-8778 |
| NPI Number | 1003002353 |
|---|---|
| Provider Enumeration Date | 09/20/2007 |
| Last Update Date | 07/13/2023 |
| Certification Date | 07/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003002353 | NPI | - | NPPES |
| 9092 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (California) | Primary |
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