WELLBOUND OF STOCKTON LLC (NPI# 1144260811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144260811 |
| Entity Type | Organization |
| Organization Name | WELLBOUND OF STOCKTON LLC |
| Other Organization Name | WELLBOUND OF STOCKTON |
| Practice Address |
3555 Deer Park Dr Suite 140 Stockton CA 95219-2306 |
| Mailing Address |
300 Santana Row Suite 300 San Jose CA 95128-2423 |
| Practice Telephone | 2099555630 |
| Practice Fax Number | 2099555635 |
| Mailing Telephone | 2099555630 |
| Mailing Fax Number | 6506256007 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2016-12-29 |
| Authorized Official Name | SUSAN L DEL BENE (SECRETARY/CFO) |
| Authorized Official Telephone | 6504043618 |
| Is Organization Subpart | Y |
| Parent Organization Name | WELLBOUND LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CDC52555F | 05 |
| Other Name | Type Code |
|---|---|
| WellBound of Stockton | Doing Business As Name - Organization |
| Street Address |
3555 DEER PARK DR SUITE 140 |
| City | STOCKTON |
| State | CA |
| Zip Code | 95219-2306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407267446 | Ivan Chicchon | Dentist | 3555 Deer Park Dr, Stockton, CA 95219-2377 | 2014-05-13 |
| 1083707822 | Vitreo-retinal Medical Group, Inc. | Ophthalmology | 3555 Deer Park Dr, Suite 180, Stockton, CA 95219-2377 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821568494 | Vanessa Paola Uribe Morales | Behavior Technician | 3620 Hammer Lane, Stockton, CA 95219 | 2018-11-27 |
| 1306316930 | Zulema Cecilia Santana | Behavior Technician | 3620 W. Hammer Ln, Stockton, CA 95219 | 2018-11-27 |
| 1699245241 | Tiana Gonzalez | Behavior Technician | 3620 W. Hammer Ln., Stockton, CA 95219 | 2018-11-27 |
| 1609346220 | Kelly Morales | Behavior Technician | 3620 W Hammer Lane, Stockton, CA 95219 | 2018-11-26 |
| 1336619956 | Mouagoleah Her | Behavior Technician | 3620 W. Hammer Lane, Stockton, CA 95219 | 2018-11-26 |
| 1750837985 | Alexsandra Trejo | Marriage & Family Therapist | 6707 Embarcadero Drive, Stockton, CA 95219 | 2016-08-28 |
| 1659764397 | Integrated Pain Treatment Center | Pain Medicine | 4312 Feather River Drive, Suite C, Stockton, CA 95219 | 2015-03-05 |
| 1790180859 | Mary Karen Papagolos | Marriage & Family Therapist | 2800 W March Ln Ste 473, Stockton, CA 95219 | 2014-10-30 |
| 1932535648 | Morton Rothbard | Urology | 4673 Pine Valley Cir., Stockton, CA 95219 | 2013-09-26 |
| 1033482591 | Michelle M Rutherford | Physical Therapist | 10200 Trinity Pkwy Ste 205, Stockton, CA 95219 | 2012-02-14 |
| Find all providers in zip 95219 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437569514 | Coral Dialysis LLC | Clinic/Center | 1810 S Fresno Ave, Stockton, CA 95206-1861 | 2014-04-29 |
| 1104190826 | Satellite Dialysis of South Stockton LLC | Clinic/Center | 590 E Harding Wy, Stockton, CA 95204-6110 | 2012-02-27 |
| 1518166594 | Stockton Kidney Clinic, LLC | Clinic/Center | 1523 E March Ln, Stockton, CA 95210 | 2007-07-11 |
| 1063586394 | Rai Care Centers of Northern California I, LLC | Clinic/Center | 3115 West March Lane, Stockton, CA 95219-2372 | 2006-11-20 |
| 1922069319 | Total Renal Care Inc | Clinic/Center | 7500 West Ln, Stockton, CA 95210-3312 | 2006-03-28 |
| 1437124476 | Dva Healthcare Renal Care Inc | Clinic/Center | 5608 N Pershing Ave, Stockton, CA 95207-4906 | 2006-02-22 |
| 1700203502 | Total Renal Care Inc | Clinic/Center | 7707 Austin Rd, Stockton, CA 95215-8312 | 2014-03-19 |
| 1790929826 | Roose Dialysis LLC | Clinic/Center | 1523 E March Ln, Ste 200, Stockton, CA 95210-5607 | 2009-04-20 |
| 1669546990 | Rai Care Centers of Northern California I, LLC | Clinic/Center | 2350 N California St, Stockton, CA 95204-5506 | 2006-11-20 |
| 1134142565 | Satellite Dialysis of Stockton LLC | Clinic/Center | 1801 E March Ln, Stockton, CA 95210-6629 | 2006-07-26 |
| Find all providers in STOCKTON | ||||
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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.