MEDICARE: HOSPICE OF SAN JOAQUIN

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
1	251G00000X	Community Based Hospice Care Agency	100000706	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518962083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE OF SAN JOAQUIN

Provider Business Mailing Address
First Line	:	3888 PACIFIC AVE
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-1953
Country	:	US
Telephone Number	:	209-957-3888
Fax Number	:	209-922-0390

Provider Business Practice Location Address
First Line	:	3888 PACIFIC AVE
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95204-1953
Country	:	US
Telephone Number	:	209-957-3888
Fax Number	:	209-957-3986

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. BARBARA TOGNOLI
Credential	:
Telephone Number	:	209-957-3888

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	11/20/2025

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Directions to “HOSPICE OF SAN JOAQUIN ” Practice Location

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