South San Joaquin County Fire

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

SOUTH SAN JOAQUIN COUNTY FIRE

Practice address

835 N Central Ave
Tracy, CA 95376-4105

Phone

(209) 831-6700

Fax

(209) 831-6732

NPI assigned

Mar 27, 2024

Organization subpart

No

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

Authorized official

Name

Jonathan Mendoza

Title

EMS Manager

Phone

(209) 831-6700

Specialties & licenses 1

Addresses

Other names 1

• South San Joaquin County Fire Authority Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1366293581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 N CENTRAL AVE",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953764105",
            "telephone_number": "209-831-6700",
            "fax_number": "209-831-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 N CENTRAL AVE",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953764105",
            "telephone_number": "209-831-6700",
            "fax_number": "209-831-6732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SAN JOAQUIN COUNTY FIRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "EMS MANAGER",
        "authorized_official_telephone_number": "209-831-6700"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South San Joaquin County Fire Authority",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Tracy, CA
• Providers in Tracy, CA by specialty
• Land Ambulance in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.