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General NPI Number Information
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NPI Number | 1538042098
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Entity Type | Organization
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Legal Business Name | SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 620 N AURORA ST
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City | STOCKTON
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State | CA
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Zip | 95202-2343
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Country | US
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Telephone | 209-468-9370
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 N CALIFORNIA ST
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City | STOCKTON
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State | CA
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Zip | 95202-1552
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Country | US
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Telephone | 209-468-8785
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Fax |
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Authorized Official
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Title or Position | INTERIM BEHAVIORAL HEALTH DIRECTOR
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Name | FAY VIEIRA
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Credential | LMFT
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Telephone | 209-468-8849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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