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NPI Code Detail

MEDICARE: YOUNG MEN'S CHRISTIAN ASSOCIATION OF SAN JOAQUIN COUNTY

MEDICARE: YOUNG MEN'S CHRISTIAN ASSOCIATION OF SAN JOAQUIN COUNTY
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
1174H00000XHealth Educator

General Provider Information

NPI Number : 1740738434
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUNG MEN'S CHRISTIAN ASSOCIATION OF SAN JOAQUIN COUNTY
Provider Business Mailing Address
First Line : 2105 W MARCH LN
Second Line : STE. 1
City : STOCKTON
State : CA
Zip : 95207-6422
Country : US
Telephone Number : 209-472-9622
Fax Number : 209-472-9625
Provider Business Practice Location Address
First Line : 2105 W MARCH LN
Second Line : STE. 1
City : STOCKTON
State : CA
Zip : 95207-6422
Country : US
Telephone Number : 209-472-9622
Fax Number : 209-472-9625
Authorized Official
Title or Position : CEO
Name : MR. RAY CALL
Credential :
Telephone Number : 209-472-9622
Provider Enumeration Date : 09/12/2016
Last Update Date : 09/12/2016

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Directions to “YOUNG MEN'S CHRISTIAN ASSOCIATION OF SAN JOAQUIN COUNTY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.