Provider Demographics
NPI:1255469110
Name:STOCKTON PREGNANCY CONTROL MEDICAL CLINIC
Entity Type:Organization
Organization Name:STOCKTON PREGNANCY CONTROL MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-465-5655
Mailing Address - Street 1:3209 N CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-3448
Mailing Address - Country:US
Mailing Address - Phone:209-465-5655
Mailing Address - Fax:209-465-0937
Practice Address - Street 1:3209 N CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-3448
Practice Address - Country:US
Practice Address - Phone:209-465-5655
Practice Address - Fax:209-465-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA243-2034-3261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center