Service First of Northern California

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0350000 Issued in CA

Legal business name

SERVICE FIRST OF NORTHERN CALIFORNIA

Practice address

102 W Bianchi Rd
Stockton, CA 95207-7132

Phone

(209) 644-6300

Fax

(209) 951-0427

NPI assigned

May 15, 2007

Organization subpart

Yes

Parent organization

SERVICE FIRST OF NORTHERN CALIFORNIAAs reported in NPPES

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

Authorized official

Name

Mr. Vernell Hill Jr.

Title

President/Ceo

Phone

(209) 644-6300

Specialties & licenses 1

Addresses

Other names 1

• Aquatic Therapy & Wellness Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Outpatient physical therapy / speech pathology certification: CCN 556587

Legal name

SERVICE FIRST OF NORTHERN CALFORNIA

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Oct 16, 2015

Last certification

Aug 20, 2018

Ownership / control type

Voluntary Non-Profit Other Than Church

Facility address

102 West Bianchi Road
Stockton, CA 95207

Part of

Service First of Northern California

Locations

Practitioners 3

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

• Brenda Shelton

  • Addiction (Substance Use Disorder) Counselor
  • Stockton, CA
  • NPI 1710297122
  NPD
• Richard Thomas Carson, LCSW

  • Clinical Social Worker
  • San Francisco, CA
  • NPI 1699836155
  NPD (past)
• Charles Robert McCormick, M.D.

  • Pediatrics Physician
  • Stockton, CA
  • NPI 1851328991
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1689880809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W BIANCHI RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952077132",
            "telephone_number": "209-644-6300",
            "fax_number": "209-951-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W BIANCHI RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952077132",
            "telephone_number": "209-644-6300",
            "fax_number": "209-951-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVICE FIRST OF NORTHERN CALIFORNIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SERVICE FIRST OF NORTHERN CALIFORNIA",
        "enumeration_date": "2007-05-15",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "VERNELL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "209-644-6300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "0350000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aquatic Therapy & Wellness",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jessica Nicole Serrano I
• Kayla Marie Serrano
• Monica Josephine Serrano
• Luisa Lizbeth Serrato
• Service First of Northern California
• Service First of Northern California
• Ramona Elizabeth Servin Barboza
• Dolores P. Servin
• Maria Socorro Sesante
• Adriana Nicole Martinez Sese, ASW

• Physical Therapist in Stockton, CA
• Providers in Stockton, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.