NPIMap

Organization Active NPI

Glom Outpatient Services Inc.

  • Adult Mental Health Clinic/Center
  • Stockton, CA
National Provider Identifier
1417537366
Registry record updated Jul 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
GLOM OUTPATIENT SERVICES INC.
Practice address
130 W Flora St
Stockton, CA 95202-1636
Phone
(844) 456-6677
Fax
(925) 336-3148
NPI assigned
Apr 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2026

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

Authorized official

Name
Dr. Allen Turner
Title
Executive Director
Phone
(925) 570-3282

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193400000X SINGLE SPECIALTY GROUP 171M00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Community/Behavioral Health Agency 251S00000X
Adult Day Care Clinic/Center 261QA0600X
Adult Mental Health Clinic/Center 261QM0850X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

130 W Flora St
Stockton, CA 95202-1636

Mailing address

3123 Independence Dr
Livermore, CA 94551-7595
Phone (925) 999-4119

Other practice location 1

1111 W Tokay St Ste A
Lodi, CA 95240-3965
Phone (844) 456-6677

Other practice location 2

1020 W Main St
Merced, CA 95340-4521
Phone (844) 456-6677

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240726001319 CA Part B Supplier - Clinic/Group Practice 8022554930 Receives reassigned benefits from 4 practitioners
Practice locations: Stockton, CA; Merced, CA; Lodi, CA

National Provider Directory

National Provider Directory
Tax ID family
Glom Substance Abuse Program10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

1020 W Main St
Merced, CA 95340
Phone (209) 330-7155

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783296000000",
    "number": "1417537366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3123 INDEPENDENCE DR",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945517595",
            "telephone_number": "925-999-4119",
            "fax_number": "925-800-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W FLORA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021636",
            "telephone_number": "844-456-6677",
            "fax_number": "925-336-3148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1111 W Tokay St Ste A",
            "address_purpose": "LOCATION",
            "city": "Lodi",
            "state": "CA",
            "postal_code": "952403965",
            "country_code": "US",
            "telephone_number": "844-456-6677",
            "fax_number": "925-336-3148",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1020 W Main St",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953404521",
            "country_code": "US",
            "telephone_number": "844-456-6677",
            "fax_number": "925-336-3148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GLOM OUTPATIENT SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-13",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "925-570-3282",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; 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.