MARY GRAHAM CHILDREN'S SHELTER – NPI #1548478142
Clinic/Center

MARY GRAHAM CHILDREN'S SHELTER is an AHC clinic located in FRENCH CAMP, CA. NPPES has assigned the NPI number 1548478142 to MARY GRAHAM CHILDREN'S SHELTER on May 18, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MARY GRAHAM CHILDREN'S SHELTER” is a dba name, the actual legal business name for this organization is SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM0801X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Mental Health (Including Community Mental Health Center)

The NPI profile was previously updated about 2 years ago on May 01, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MARY GRAHAM CHILDREN'S SHELTER below.

NPI Profile for
SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES

NPI Number
1548478142
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES
Doing Business As (dba): MARY GRAHAM CHILDREN'S SHELTER
Primary location
6861 MARY GRAHAM LANE
FRENCH CAMP, CA 95231
Phone: (209) 468-6966 Fax: (209) 468-2399
Mailing address
1212 N CALIFORNIA ST
STOCKTON, CA 95202-1552
Phone: (209) 468-8778 Fax: (209) 468-2399
Organization Subpart
No
Authorized Official
GENEVIEVE VALENTINE
DIRECTOR-BEHAVIORAL HEALTH SERVICES
Phone: (209) 468-8750
Updated
Certification Date
May 01, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for MARY GRAHAM CHILDREN'S SHELTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidCA9008
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.