ST. JOSEPH'S SURGERY CENTER LP (NPI# 1619974219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619974219 |
| Entity Type | Organization |
| Organization Name | ST. JOSEPH'S SURGERY CENTER LP |
| Practice Address |
1800 N California St Ste 1 Stockton CA 95204-6019 |
| Practice Telephone | 2094676316 |
| Practice Fax Number | 2094616895 |
| Mailing Telephone | 2094676316 |
| Mailing Fax Number | 2094616895 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2018-03-05 |
| Authorized Official Name | JENETHA D MORAN (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 9727633893 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
EXEMPT FROM LICE | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE RAILROAD CARRIER | P00215810 | 01 |
| CA | MISC | CA0300001807 | 01 |
| CA | 05-C0001711 | 05 |
| Street Address |
1800 N CALIFORNIA ST STE 1 |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204-6019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174940 | Simon Yeung | Pharmacist | 1800 N California St, Stockton, CA 95204-6019 | 2020-11-04 |
| 1275140584 | Rajwinder K Gill | Registered Nurse | 1800 N California St, Stockton, CA 95204-6019 | 2020-09-30 |
| 1447865787 | Rinky Saini Prasad | Registered Nurse | 1800 N California St, Stockton, CA 95204-6019 | 2020-09-14 |
| 1821609611 | Dustin Tien Le | Pharmacist | 1800 N California St, Stockton, CA 95204-6019 | 2020-08-14 |
| 1013534254 | Nancy Thi Nguyen | Speech-Language Pathologist | 1800 N California St, Stockton, CA 95204-6019 | 2020-07-04 |
| 1861015646 | Sana Mohyud Din Chaudhary | Student in an Organized Health Care Education/Training Program | 1800 N California St, Stockton, CA 95204-6019 | 2020-05-27 |
| 1942822184 | Kenneth Jerome Hainsworth | Student in an Organized Health Care Education/Training Program | 1800 N California St, Stockton, CA 95204-6019 | 2020-05-11 |
| 1083236368 | Chase Rogers | Student in an Organized Health Care Education/Training Program | 1800 N California St, Stockton, CA 95204-6019 | 2020-05-10 |
| 1093336919 | Joel Rabara | Respiratory Therapist, Registered | 1800 N California St, Stockton, CA 95204-6019 | 2020-05-01 |
| 1093336158 | Kendall Bower | Speech-Language Pathologist | 1800 N California St, Stockton, CA 95204-6019 | 2020-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
| 1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
| 1033565544 | Philip John Brereton | Orthotist | 466 E Harding Way, Stockton, CA 95204 | 2016-05-13 |
| 1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
| 1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
| 1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
| Find all providers in zip 95204 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922625995 | National Surgical Centers Stockton, LLC | Clinic/Center | 415 E Harding Way Ste E, Stockton, CA 95204-6118 | 2020-06-25 |
| 1316190796 | Sutter Gould Medical Foundation | Clinic/Center | 8011 Don Ave, Stockton, CA 95209 | 2008-10-29 |
| 1609041813 | Dental Surgery Centers of America | Clinic/Center | 1523 E March Ln Ste A, Stockton, CA 95210-5607 | 2008-04-29 |
| 1225138647 | American Dental Surgery Centers, Inc. | Clinic/Center | 1523 E. March Ln., Suite 100, Stockton, CA 95210-5663 | 2006-09-25 |
| 1730112178 | San Joaquin Laser and Surgery Center Inc | Clinic/Center | 1805 N California St Ste 101a, Stockton, CA 95204-6032 | 2006-07-09 |
| 1245285857 | Ambulatory Surgery Center of Eager Steven E Md Gen Ptr | Clinic/Center | 2388 N California St, Stockton, CA 95204-5506 | 2006-05-23 |
| 1417405234 | Psc Stockton Outpatient Surgery Center, LLC | Clinic/Center | 1805 N California St, Suite 405, Stockton, CA 95204-6037 | 2016-09-21 |
| 1467825844 | Sutter Valley Medical Foundation | Clinic/Center | 8011 Don Ave, Stockton, CA 95209-2841 | 2015-11-05 |
| 1598158487 | California Street Outpatient Surgery Center, LLC | Clinic/Center | 1805 N California St, Suite 405, Stockton, CA 95204-6037 | 2015-03-17 |
| 1982942298 | Stockton Outpatient Surgery Center LLC | Clinic/Center | 2388 N California St, Stockton, CA 95204-5506 | 2013-01-21 |
| 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.