CHILDREN'S HOME OF STOCKTON (NPI# 1013480862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013480862 |
| Entity Type | Organization |
| Organization Name | CHILDREN'S HOME OF STOCKTON |
| Other Organization Name | ASPEN COTTAGE |
| Practice Address |
1222 E Lindsay St Stockton CA 95205-4413 |
| Mailing Address |
430 N Pilgrim St Stockton CA 95205-4428 |
| Practice Telephone | 2094660853 |
| Mailing Telephone | 2094660853 |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-01-15 |
| Authorized Official Name | JOELLE GOMEZ (CEO) |
| Authorized Official Telephone | 2094660853 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHILDREN'S HOME OF STOCKTON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 397002553 | 05 |
| Other Name | Type Code |
|---|---|
| Aspen Cottage | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558834309 | Children's Home of Stockton | Residential Treatment Facility, Emotionally Disturbed Children | 1224 E Lindsay St, Stockton, CA 95205-4413 | 2019-01-04 |
| 1831662683 | Children's Home of Stockton | Residential Treatment Facility, Emotionally Disturbed Children | 1236 E Lindsay St, Stockton, CA 95205-4413 | 2019-01-04 |
| 1477026334 | Children's Home of Stockton | Residential Treatment Facility, Emotionally Disturbed Children | 1227 E Lindsay St, Stockton, CA 95205-4410 | 2019-01-03 |
| 1265905129 | Children's Home of Stockton | Residential Treatment Facility, Emotionally Disturbed Children | 1658 W Euclid Ave, Stockton, CA 95204-2907 | 2019-01-03 |
| 1790265023 | Children's Home of Stockton | Residential Treatment Facility, Emotionally Disturbed Children | 430 N Pilgrim St, Stockton, CA 95205-4428 | 2018-08-16 |
| Street Address |
1222 E LINDSAY ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95205-4413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801081 | Telegenx, LLC | Durable Medical Equipment & Medical Supplies | 127 S Locust St, Stockton, CA 95205 | 2020-08-12 |
| 1487130191 | Rassiwala Dental Corporation | Dentist | 2043 E Fremont St Ste 8, Stockton, CA 95205 | 2018-07-16 |
| 1518464692 | Szarisse Fernandez | Pharmacist | 2040 E. Mariposa Rd., Stockton, CA 95205 | 2018-04-06 |
| 1467820019 | San Joaquin County Bhs | Non-emergency Medical Transport (VAN) | 1149 N. El Dorado St., Stockton, CA 95205 | 2015-09-11 |
| 1346617651 | Kevin G.y. Tom | Pharmacist | 1528 Fremont St, Stockton, CA 95205 | 2015-08-24 |
| 1578749149 | Peebles Family Care Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 404 North Broadway Ave, Stockton, CA 95205 | 2008-01-14 |
| 1780874149 | Mv Transportation | Non-emergency Medical Transport (VAN) | 1250 South Wilson Way, Mv Transportation Ste #a1, Stockton, CA 95205 | 2007-07-31 |
| 1467513549 | Stockton Pharmacy | Pharmacy | 3330 E Main St, Stockton, CA 95205 | 2006-12-13 |
| 1174155170 | Phillip Brandon Long | Pharmacist | 2040 E Mariposa Rd, Stockton, CA 95205 | 2020-02-07 |
| 1558904136 | Angela Moss Burns | Counselor | 430 N Pilgrim St, Stockton, CA 95205 | 2019-10-25 |
| Find all providers in zip 95205 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558834309 | Children's Home of Stockton | Residential Treatment Facility, Emotionally Disturbed Children | 1224 E Lindsay St, Stockton, CA 95205-4413 | 2019-01-04 |
| 1831662683 | Children's Home of Stockton | Residential Treatment Facility, Emotionally Disturbed Children | 1236 E Lindsay St, Stockton, CA 95205-4413 | 2019-01-04 |
| 1477026334 | Children's Home of Stockton | Residential Treatment Facility, Emotionally Disturbed Children | 1227 E Lindsay St, Stockton, CA 95205-4410 | 2019-01-03 |
| 1265905129 | Children's Home of Stockton | Residential Treatment Facility, Emotionally Disturbed Children | 1658 W Euclid Ave, Stockton, CA 95204-2907 | 2019-01-03 |
| 1790265023 | Children's Home of Stockton | Residential Treatment Facility, Emotionally Disturbed Children | 430 N Pilgrim St, Stockton, CA 95205-4428 | 2018-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.