NPIMap

Organization Active NPI

Peer Recovery Services

  • Community Health Worker
  • Stockton, CA
National Provider Identifier
1033074968
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
PEER RECOVERY SERVICES
Practice address
1109 N California St
Stockton, CA 95202-1537
Phone
(209) 451-3977
NPI assigned
Dec 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jonathan Vickrey
Title
Chief Financial & Operating Officer
Phone
(209) 509-4727

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X Primary
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X

Addresses

Primary practice location

1109 N California St
Stockton, CA 95202-1537

Mailing address

1109 N California St
Stockton, CA 95202-1537
Phone (209) 451-3977

National Provider Directory

National Provider Directory

Locations

1109 N California St
Stockton, CA 95202
Phone (209) 208-5346

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1766448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1033074968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021537",
            "telephone_number": "209-451-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021537",
            "telephone_number": "209-451-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEER RECOVERY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-23",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "VICKREY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL & OPERATING OFFICER",
        "authorized_official_telephone_number": "209-509-4727"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.