Healthcare Provider Details

I. General information

NPI: 1265329015
Provider Name (Legal Business Name): UNITED WAY OF SAN JOAQUIN COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 N PERSHING AVE STE 2B
STOCKTON CA
95203-2154
US

IV. Provider business mailing address

777 N PERSHING AVE STE 2B
STOCKTON CA
95203-2154
US

V. Phone/Fax

Practice location:
  • Phone: 209-469-6980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH NG MAYBERRY
Title or Position: DIRECTOR OF OPERATION
Credential:
Phone: 209-905-4501