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General NPI Number Information
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NPI Number | 1427629203
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Entity Type | Organization
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Legal Business Name | SAN JOAQUIN COUNTY WHOLE PERSON CARE
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Dates
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Enumeration Date | 07/02/2021
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 7000 MICHAEL CANLIS WAY
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City | FRENCH CAMP
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State | CA
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Zip | 95231-9781
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Country | US
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Telephone | 209-468-4550
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Fax | 209-468-5274
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Provider Business Mailing Address
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Address Line | 7000 MICHAEL CANLIS WAY
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City | FRENCH CAMP
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State | CA
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Zip | 95231-9781
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Country | US
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Telephone | 209-468-4550
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Fax | 209-468-5274
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Authorized Official
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Title or Position | CHS ADMINISTRATOR
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Name | LAKISHA HOLTON
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Credential | DNP, APRN, FNP-C
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Telephone | 209-468-4487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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