AEGIS TREATMENT CENTERS, LLC (NPI# 1710030325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710030325 |
| Entity Type | Organization |
| Organization Name | AEGIS TREATMENT CENTERS, LLC |
| Other Organization Name | DBA: HEALTHY CONNECTIONS |
| Practice Address |
1947 N California St Suite B and C Stockton CA 95204-6029 |
| Mailing Address |
7246 Remmet Ave Canoga Park CA 91303-1531 |
| Practice Telephone | 2094630870 |
| Practice Fax Number | 2094630560 |
| Mailing Telephone | 8182060360 |
| Mailing Fax Number | 8182060371 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2016-09-30 |
| Authorized Official Name | MR. ALEXANDER DODD (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8182060360 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
39-11 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| dba: Healthy Connections | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083224141 | Aegis Treatment Centers, LLC | Clinic/Center | 1450 Bessie Ave Ste B, Tracy, CA 95376-3456 | 2020-08-04 |
| 1326698887 | Aegis Treatment Centers, LLC | Clinic/Center | 2107, 2109 & 2113 1st St, Eureka, CA 95501-0840 | 2019-09-17 |
| 1548819550 | Aegis Treatment Centers, LLC | Clinic/Center | 1111 W Inyokern Rd Ste B, Ridgecrest, CA 93555-2370 | 2019-09-11 |
| 1760922207 | Aegis Treatment Centers, LLC | Clinic/Center | 1137 Hartnell Avenue, Suite E, 1141, 1145 & 1147 Hartnell Avenue, Redding, CA 96002-2113 | 2017-03-02 |
| 1649669979 | Aegis Treatment Centers, LLC | Clinic/Center | 541 S Ham Ln Ste A&b, Lodi, CA 95242-3530 | 2015-01-09 |
| 1134565740 | Aegis Treatment Centers, LLC | Clinic/Center | 955 W. Center Street, Suites 12a, 12b & 14, Manteca, CA 95337 | 2013-05-22 |
| 1851444376 | Aegis Treatment Centers, LLC | Clinic/Center | 1839 S. El Dorado Street, Stockton, CA 95206-2025 | 2007-01-19 |
| 1316003601 | Aegis Treatment Centers, LLC | Clinic/Center | 2321 Pontius Ave, Los Angeles, CA 90064-1809 | 2006-12-29 |
| 1972669257 | Aegis Treatment Centers, LLC | Clinic/Center | 1322 N Avalon Blvd, Wilmington, CA 90744-2639 | 2006-12-29 |
| 1104982495 | Aegis Treatment Centers, LLC | Clinic/Center | 1343 W Main St Ste A&b, 1349 W. Main Street, Merced, CA 95340-4438 | 2006-12-29 |
| Street Address |
1947 N CALIFORNIA ST SUITE B AND C |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204-6029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326080862 | Matrix Rehabilitation, Inc. | Clinic/Center | 1947 N California St, Suite B, Stockton, CA 95204-6029 | 2006-06-11 |
| 1093345183 | Kurtis Woody | Licensed Vocational Nurse | 1947 N California St, Stockton, CA 95204-6029 | 2020-01-17 |
| 1588211502 | Roberta Jean Lewis-goldfine | Licensed Vocational Nurse | 1947 N California St, Stockton, CA 95204-6029 | 2019-08-23 |
| 1568945822 | Pa Gnia Yang | Counselor | 1947 N California St, Stockton, CA 95204-6029 | 2018-09-12 |
| 1639669070 | Sioban Regina Mersaroli | Counselor | 1947 N California St, Stockton, CA 95204-6029 | 2018-05-11 |
| 1720580970 | Rana Amjadi Khan | Counselor | 1947 N California St, Stockton, CA 95204-6029 | 2018-03-05 |
| 1548793656 | Marc Heslop | Counselor | 1947 N California St, Stockton, CA 95204-6029 | 2017-04-05 |
| 1376908814 | Stephen Bradley Machado II | Counselor | 1947 N California St, Suite B, Stockton, CA 95204-6029 | 2015-12-29 |
| 1295117174 | Steven Ryan | Case Manager/Care Coordinator | 1947 N California St, B, Stockton, CA 95204-6029 | 2015-06-26 |
| 1083007033 | Josepph Daniel Isquierdo | Counselor | 1947 N California St, Suite B, Stockton, CA 95204-6029 | 2015-03-16 |
| 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 | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164082277 | Elizabeth Perez | Clinic/Center | 1982 S Drake Ave, Stockton, CA 95215-7449 | 2019-06-20 |
| 1851444376 | Aegis Treatment Centers, LLC | Clinic/Center | 1839 S. El Dorado Street, Stockton, CA 95206-2025 | 2007-01-19 |
| 1558554915 | Pacific Valley Recovery Center Incorporated | Clinic/Center | 820 E Main St, Stockton, CA 95202-3129 | 2007-08-20 |
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| 1003427337 | Restorative Partners, Inc. | Clinic/Center | 3220 S Higuera St Ste 103a, San Luis Obispo, CA 93401-2023 | 2020-08-11 |
| 1255941597 | Pathways Recovery | Clinic/Center | 4904 Hollycrest Way, Fair Oaks, CA 95628-5114 | 2020-08-02 |
| 1104435734 | New Life Health Authority / Dba New Life LLC | Clinic/Center | 280 E Standley St, Ukiah, CA 95482-4414 | 2020-07-29 |
| 1043829971 | House of Hope Foundation Inc | Clinic/Center | 227 W 9th St, San Pedro, CA 90731-3711 | 2020-07-27 |
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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.