# SAN JOAQUIN COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558619270
- **Authorized official:** MICHELLE M WARTHAN (MSW INTERN)
- **Authorized official phone:** (209) 406-1757

## Contact information

- **Practice address:** 1414 N CALIFORNIA ST, STOCKTON, CA 95202-1515
- **Practice address phone:** (209) 468-2385
- **Practice address fax:** (209) 468-8024
- **Mailing address:** 1414 N CALIFORNIA ST, STOCKTON, CA 95202-1515
- **Mailing address phone:** (209) 468-2385
- **Mailing address fax:** (209) 468-8024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 08/28/2012
- **Last updated:** 08/28/2012