Vance Marriage and Family Therapy, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

43158 Issued in CA

Legal business name

VANCE MARRIAGE AND FAMILY THERAPY, INC.

Practice address

1545 Saint Marks PLZ Ste 5
Stockton, CA 95207-6411

Phone

(209) 598-1630

Fax

(209) 955-1050

NPI assigned

Jul 9, 2018

Organization subpart

No

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

Authorized official

Name

Carole VanceNPI 1306024666

Title

Ceo

Phone

(209) 598-1630

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Carole Marie Vance, LMFT

  • Marriage & Family Therapist
  • Stockton, CA
  • NPI 1306024666
  NPD (past) Authorized official
• Pamela Marie Campbell, MFT INTERN

  • Marriage & Family Therapist
  • Stockton, CA
  • NPI 1447506878
  NPD (past)
• Denisha Wright, LCSW

  • Clinical Social Worker
  • Stockton, CA
  • NPI 1417337809
  NPD (past)

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1144716549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 SAINT MARKS PLZ STE 5",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076411",
            "telephone_number": "209-598-1630",
            "fax_number": "209-955-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 SAINT MARKS PLZ STE 5",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952076411",
            "telephone_number": "209-598-1630",
            "fax_number": "209-955-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCE MARRIAGE AND FAMILY THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-09",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "VANCE",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-598-1630"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": "43158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Van Pernis
• Van Pharmacy
• Van Sicklen DDS Inc
• Alexandra Van Zuyen
• Shylah Vanasse
• Carole Marie Vance, LMFT
• Roanne Vander Veen
• Benjamin H Vanderjack
• Allura Ashton Vanderwoude
• Norman J. Vanduker, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Stockton, CA
• Providers in Stockton, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.