NPIMap

Organization Active NPI

San Joaquin County Behavioral Health Services

Doing business as San Joaquin County MH Services Tracy Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tracy, CA
National Provider Identifier
1306051370
Registry record updated May 2, 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
Doing business as
San Joaquin County MH Services Tracy Clinic
Practice address
220 W 11TH St
Tracy, CA 95376-3944
Phone
(209) 468-8778
Fax
(209) 468-2399
NPI assigned
May 13, 2007
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Genevieve Valentine, LMFT
Title
Director-Behavioral Health Services
Phone
(209) 468-8750

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

220 W 11TH St
Tracy, CA 95376-3944

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
9048MedicaidCA

Other names 1

  • San Joaquin County MH Services Tracy Clinic Doing business as

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
San Joaquin County94 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

220 W 11th St
Tracy, CA 95376
Phone (209) 468-8778

Practitioners & affiliated clinicians

Practitioners 20

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 20

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": "1714608000000",
    "number": "1306051370",
    "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": "220 W 11TH ST",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763944",
            "telephone_number": "209-468-8778",
            "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": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "VALENTINE",
        "authorized_official_first_name": "GENEVIEVE",
        "authorized_official_title_or_position": "DIRECTOR-BEHAVIORAL HEALTH SERVICES",
        "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": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9048",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Joaquin County MH Services Tracy Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Joaquin County MH Services Tracy Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.