Provider Demographics
NPI:1427629203
Name:SAN JOAQUIN COUNTY WHOLE PERSON CARE
Entity type:Organization
Organization Name:SAN JOAQUIN COUNTY WHOLE PERSON CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAKISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, FNP-C
Authorized Official - Phone:209-468-4487
Mailing Address - Street 1:7000 MICHAEL CANLIS WAY
Mailing Address - Street 2:
Mailing Address - City:FRENCH CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:95231-9781
Mailing Address - Country:US
Mailing Address - Phone:209-468-4550
Mailing Address - Fax:209-468-5274
Practice Address - Street 1:7000 MICHAEL CANLIS WAY
Practice Address - Street 2:
Practice Address - City:FRENCH CAMP
Practice Address - State:CA
Practice Address - Zip Code:95231-9781
Practice Address - Country:US
Practice Address - Phone:209-468-4550
Practice Address - Fax:209-468-5274
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:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management