Provider Demographics
NPI:1427629203
Name:SAN JOAQUIN COUNTY HEALTH CARE SERVICES
Entity type:Organization
Organization Name:SAN JOAQUIN COUNTY HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:209-468-7780
Mailing Address - Street 1:500 W HOSPITAL RD
Mailing Address - Street 2:BENTON HALL EAST
Mailing Address - City:FRENCH CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:95231-9693
Mailing Address - Country:US
Mailing Address - Phone:209-468-5610
Mailing Address - Fax:209-468-5615
Practice Address - Street 1:500 W HOSPITAL RD
Practice Address - Street 2:BENTON HALL EAST
Practice Address - City:FRENCH CAMP
Practice Address - State:CA
Practice Address - Zip Code:95231-9693
Practice Address - Country:US
Practice Address - Phone:209-468-5610
Practice Address - Fax:209-468-5615
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SAN JOAQUIN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management