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NPI Code Detail

MEDICARE: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES

MEDICARE: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251K00000XPublic Health or Welfare Agency

General Provider Information

NPI Number : 1356453831
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES
Provider Business Mailing Address
First Line : 1601 E HAZELTON AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95205-6229
Country : US
Telephone Number : 209-468-8934
Fax Number : 209-468-2072
Provider Business Practice Location Address
First Line : 1601 E HAZELTON AVE
Second Line :
City : STOCKTON
State : CA
Zip : 95205-6229
Country : US
Telephone Number : 209-468-8934
Fax Number : 209-468-2072
Authorized Official
Title or Position : CLINIC PROGRAM COORDINATOR
Name : MS. CHARLOTTE V. HUNTER-BROWH
Credential :
Telephone Number : 209-468-8934
Provider Enumeration Date : 08/31/2006
Last Update Date : 03/12/2014

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Directions to “SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ” Practice Location

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