NPIMap

Organization Active NPI

San Joaquin County Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lodi, CA
National Provider Identifier
1265647234
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES
Practice address
1209 W Tokay Street
Suite 1, 3, 5, 7, 12, 14, and 16
Lodi, CA 95240-3845
Phone
(209) 468-8700
Fax
(209) 468-2399
NPI assigned
May 13, 2007
Last updated
May 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Genevieve Valentine, LMFTNPI 1689836272
Title
Director of Behavioral Health
Phone
(209) 468-8750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

1209 W Tokay Street
Suite 1, 3, 5, 7, 12, 14, and 16
Lodi, CA 95240-3845

Mailing address

1212 N California St
Stockton, CA 95202-1552
Phone (209) 468-8778

Other identifiers 1

IdentifierTypeStateIssuer
3924MedicaidCA

Other names 1

  • San Joaquin County-MH Services Lodi Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050915001095 CA Part B Supplier - Clinic/Group Practice 6002703436 Receives reassigned benefits from 189 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lodi, CA; Manteca, CA; Stockton, CA; Tracy, CA

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Public HLTH Lab San Joa94 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1209 W Tokay St
Ste 1
Lodi, CA 95240
Phone (209) 468-8700

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1265647234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021552",
            "telephone_number": "209-468-8778",
            "fax_number": "209-468-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 W TOKAY STREET",
            "address_2": "SUITE 1, 3, 5, 7, 12, 14, AND 16",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403845",
            "telephone_number": "209-468-8700",
            "fax_number": "209-468-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-13",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "VALENTINE",
        "authorized_official_first_name": "GENEVIEVE",
        "authorized_official_title_or_position": "DIRECTOR OF BEHAVIORAL HEALTH",
        "authorized_official_telephone_number": "209-468-8750",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3924",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Joaquin County-MH Services Lodi Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.