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Organization

COMMUNITY BEHAVIORAL INTERVENTION SERVICES

Active
Other names
University of the Pacific
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CRIS T. CLAY MA (EXECUTIVE DIRECTOR)
(209) 946-2132
Entity
Organization

Contact information

Practice address
3601 PACIFIC AVE, PSYCHOLOGY DEPARTMENT, STOCKTON, CA 95211-0110
(209) 946-2132
(209) 946-2284
Mailing address
3601 PACIFIC AVE, PSYCHOLOGY DEPARTMENT, STOCKTON, CA 95211-0110
(209) 946-2132
(209) 946-2284

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9043
MEDICAL
CA
Enumeration date
06/04/2007
Last updated
08/22/2020
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