Community Re-Entry Program

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Legal business name

COMMUNITY RE-ENTRY PROGRAM

Practice address

3601 Pacific Ave
Stockton, CA 95211-0110

Phone

(209) 256-3446

NPI assigned

Apr 1, 2013

Last updated

Apr 1, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cris ClayNPI 1508989849

Title

Program Director

Phone

(209) 256-3446

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Cris Thomas Clay, MA

  • Mental Health Counselor
  • Stockton, CA
  • NPI 1508989849
  Authorized official Same address or phone

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1477896173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 PACIFIC AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952110110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 PACIFIC AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952110110",
            "telephone_number": "209-256-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RE-ENTRY PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-01",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "CRIS",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "209-256-3446"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Medical Centers, Inc.
• Community Medical Centers, Inc.
• Community Medical Centers, Inc. (Channel Medical Center)
• Community Medical Team, Inc.
• Community Re-Entry Program
• Community Re-Organization Program
• Compliance360 LLC
• Sherri K Conant, MSW
• Marla Conboy
• Mitchel Concepcion

• Student in an Organized Health Care Education/Training Program in Stockton, CA
• Providers in Stockton, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.