Healthcare Provider Details

I. General information

NPI: 1396544334
Provider Name (Legal Business Name): MOHAWA BEHAVIORAL HEALTH APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3031 W MARCH LN STE 134
STOCKTON CA
95219-6578
US

IV. Provider business mailing address

3031 W MARCH LN STE 134
STOCKTON CA
95219-6578
US

V. Phone/Fax

Practice location:
  • Phone: 408-610-2040
  • Fax: 408-380-2170
Mailing address:
  • Phone: 408-610-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: NAVMOON SINGH MANN
Title or Position: CEO/PRESIDENT
Credential: M.D.
Phone: 408-610-2040