NPIMap

Organization Active NPI

Victor Community Support Services, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Stockton, CA
National Provider Identifier
1932251980
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
VICTOR COMMUNITY SUPPORT SERVICES, INC.
Practice address
2495 W March LN
Suite 125
Stockton, CA 95207-8251
Phone
(209) 465-1080
NPI assigned
Jan 18, 2007
Last updated
Aug 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Authorized official

Name
Ms. Angie R Wiechert
Title
Manager of Financial Planning
Phone
(530) 230-1210

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

2495 W March LN
Suite 125
Stockton, CA 95207-8251

Mailing address

1360 E Lassen Ave
Chico, CA 95973-7823
Phone (530) 893-0758

Other identifiers 1

IdentifierTypeStateIssuer
01042OtherCALEGAL ENTITY #

Other names 1

  • Victor Community Support Services, Stockton Other name

National Provider Directory

National Provider Directory
Tax ID family
Victor Community Support Services Inc34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Locations

2495 W March Ln
Ste 125
Stockton, CA 95207
Phone (209) 465-2709

Practitioners & affiliated clinicians

Practitioners 276

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.

View all 276

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1932251980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 E LASSEN AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959737823",
            "telephone_number": "530-893-0758",
            "fax_number": "530-893-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 W MARCH LN",
            "address_2": "SUITE 125",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078251",
            "telephone_number": "209-465-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR COMMUNITY SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "WIECHERT",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER OF FINANCIAL PLANNING",
        "authorized_official_telephone_number": "530-230-1210",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEGAL ENTITY #",
            "identifier": "01042",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victor Community Support Services, Stockton",
            "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 29, 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.