Intellicare Services LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

INTELLICARE SERVICES LLC

Practice address

10410 Rudder Way
Stockton, CA 95209-4348

Phone

(209) 406-0817

Fax

(209) 451-4997

NPI assigned

Feb 20, 2015

Organization subpart

No

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

Authorized official

Name

Gilda Dizon, RN, BSN

Title

President/Owner

Phone

(209) 406-0817

Specialties & licenses 1

Addresses

Other names 1

• INTELLICARE SERVICES Doing business as

Tax ID family

Intellicare Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Intellicare Services LLC

  • Case Management Agency
  • Stockton, CA
  • NPI 1760873533
  NPD tax ID

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424390400000",
    "number": "1235521774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 N EDISON ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952045633",
            "telephone_number": "209-406-0817",
            "fax_number": "209-451-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10410 RUDDER WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952094348",
            "telephone_number": "209-406-0817",
            "fax_number": "209-451-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTELLICARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-02-20",
        "status": "A",
        "authorized_official_last_name": "DIZON",
        "authorized_official_first_name": "GILDA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "209-406-0817",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTELLICARE SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Case Management Agency in Stockton, CA
• Providers in Stockton, CA by specialty
• Case Management Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.