| Lutheran Social Services Of Northern California | |
|
4550 N Pershing Ave Ste 120 Stockton CA 95207-6737 | |
| (916) 900-6140 | |
| Not Available |
| Full Name | Lutheran Social Services Of Northern California |
|---|---|
| Speciality | Case Management |
| Location | 4550 N Pershing Ave Ste 120, Stockton, California |
| Authorized Official Name and Position | Mixtlicoatl R Gonzalez (DATA SYSTEMS MANAGER) |
| Authorized Official Contact | 9169000614 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Social Services Of Northern California 4390 47th Ave Sacramento CA 95824-3700 Ph: (916) 900-6140 | Lutheran Social Services Of Northern California 4550 N Pershing Ave Ste 120 Stockton CA 95207-6737 Ph: (916) 900-6140 |
| NPI Number | 1023766185 |
|---|---|
| Provider Enumeration Date | 03/16/2022 |
| Last Update Date | 04/05/2022 |
| Certification Date | 04/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023766185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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