Organization Active NPI

Friends Outside

  • Health Educator
  • Stockton, CA
National Provider Identifier
1992528624
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
FRIENDS OUTSIDE
Practice address
1148 W Fremont St
Stockton, CA 95203
Phone
(209) 955-0701
Fax
(209) 955-0735
NPI assigned
Nov 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Authorized official

Name
Michael E Sorensen
Title
Executive Director
Phone
(209) 955-0701

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X Primary

Addresses

Primary practice location

1148 W Fremont St
Stockton, CA 95203

Mailing address

PO Box 4085
Stockton, CA 95204
Phone (209) 955-0701

National Provider Directory

National Provider Directory

Locations

1148 W Fremont St
Stockton, CA 95203
Phone (209) 955-0701

Practitioners & affiliated clinicians

Practitioners 1

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": "1730419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1992528624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4085",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95204",
            "telephone_number": "209-955-0701",
            "fax_number": "209-955-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 W FREMONT ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95203",
            "telephone_number": "209-955-0701",
            "fax_number": "209-955-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDS OUTSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "209-955-0701"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Nov 1, 2024; 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.