Organization
VANCE MARRIAGE AND FAMILY THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLE VANCE (CEO)
(209) 598-1630
Entity
Organization
Contact information
Practice address
1545 SAINT MARKS PLZ STE 5, STOCKTON, CA 95207-6411
(209) 598-1630
(209) 955-1050
Mailing address
1545 SAINT MARKS PLZ STE 5, STOCKTON, CA 95207-6411
(209) 598-1630
(209) 955-1050
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
43158
CA
Other
Enumeration date
07/09/2018
Last updated
10/25/2018
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