Organization
FRIENDS OUTSIDE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL E SORENSEN (EXECUTIVE DIRECTOR)
(209) 955-0701
Entity
Organization
Contact information
Practice address
1148 W FREMONT ST, STOCKTON, CA 95203
(209) 955-0701
(209) 955-0735
Mailing address
PO BOX 4085, STOCKTON, CA 95204
(209) 955-0701
(209) 955-0735
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
11/01/2024
Last updated
11/01/2024
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