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General NPI Number Information
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NPI Number | 1942022975
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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 | 10/30/2024
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 620 N AURORA ST STE 312
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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 | 209-468-8486
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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 | 209-468-0603
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BEHAVIORAL HEALTH
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Name | GENEVIEVE VALENTINE
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Credential | LMFT
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Telephone | 209-468-8887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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