NPIMap

Organization Active NPI

Community Behavioral Intervention Services

  • Community/Behavioral Health Agency
  • Stockton, CA
National Provider Identifier
1669674446
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY BEHAVIORAL INTERVENTION SERVICES
Practice address
3601 Pacific Ave
Psychology Department
Stockton, CA 95211-0110
Phone
(209) 946-2132
Fax
(209) 946-2284
NPI assigned
Jun 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Cris T. Clay, MANPI 1508989849
Title
Executive Director
Phone
(209) 946-2132

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

3601 Pacific Ave
Psychology Department
Stockton, CA 95211-0110

Mailing address

3601 Pacific Ave
Psychology Department
Stockton, CA 95211-0110
Phone (209) 946-2132

Other identifiers 1

IdentifierTypeStateIssuer
9043OtherCAMEDICAL

Other names 1

  • University of the Pacific Other name

National Provider Directory

National Provider Directory
Tax ID family
University of the Pacific29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669674446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 PACIFIC AVE",
            "address_2": "PSYCHOLOGY DEPARTMENT",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952110110",
            "telephone_number": "209-946-2132",
            "fax_number": "209-946-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 PACIFIC AVE",
            "address_2": "PSYCHOLOGY DEPARTMENT",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952110110",
            "telephone_number": "209-946-2132",
            "fax_number": "209-946-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BEHAVIORAL INTERVENTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "CRIS",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "209-946-2132",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "9043",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of the Pacific",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 22, 2020; 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.