NPIMap

Organization Active NPI

Asian Pacific Self-Development and Residential Association

  • Community Health Worker
  • Stockton, CA
National Provider Identifier
1033805478
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Legal business name
ASIAN PACIFIC SELF-DEVELOPMENT AND RESIDENTIAL ASSOCIATION
Practice address
3830 Alvarado Ave Ste C
Stockton, CA 95204-2350
Phone
(209) 944-1700
Fax
(209) 941-9516
NPI assigned
Apr 17, 2023
Last updated
Apr 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Authorized official

Name
Mrs. Sovanna Koeurt
Title
Executive Director
Phone
(209) 513-7618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X NU Primary

Addresses

Primary practice location

3830 Alvarado Ave Ste C
Stockton, CA 95204-2350

Mailing address

3830 Alvarado Ave Ste C
Stockton, CA 95204-2350
Phone (209) 513-7618

National Provider Directory

National Provider Directory

Locations

3830 Alvarado Ave
Ste C
Stockton, CA 95204
Phone (209) 944-1700

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1033805478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 ALVARADO AVE STE C",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952042350",
            "telephone_number": "209-513-7618",
            "fax_number": "209-941-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 ALVARADO AVE STE C",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952042350",
            "telephone_number": "209-944-1700",
            "fax_number": "209-941-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASIAN PACIFIC SELF-DEVELOPMENT AND RESIDENTIAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "KOEURT",
        "authorized_official_first_name": "SOVANNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "209-513-7618",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "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 Apr 17, 2023; 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.