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General NPI Number Information
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NPI Number | 1790265023
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Entity Type | Organization
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Legal Business Name | CHILDREN'S HOME OF STOCKTON
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Dates
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Enumeration Date | 08/16/2018
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 430 N PILGRIM ST
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City | STOCKTON
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State | CA
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Zip | 95205-4428
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Country | US
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Telephone | 209-466-0853
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Fax | 209-466-6808
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Provider Business Mailing Address
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Address Line | 430 N PILGRIM ST
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City | STOCKTON
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State | CA
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Zip | 95205-4428
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Country | US
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Telephone | 209-466-0853
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Fax | 209-466-6808
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Authorized Official
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Title or Position | HEAD OF SERVICE
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Name | JANAE ALYCE REINHARDT
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Credential | LCSW
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Telephone | 209-466-0853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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