Provider Demographics
NPI:1265815492
Name:THE STOCKTON THERAPY NETWORK
Entity Type:Organization
Organization Name:THE STOCKTON THERAPY NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAPLES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:209-406-8497
Mailing Address - Street 1:343 E MAIN ST STE 702
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202-2977
Mailing Address - Country:US
Mailing Address - Phone:209-406-8497
Mailing Address - Fax:
Practice Address - Street 1:343 E MAIN ST STE 702
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-2977
Practice Address - Country:US
Practice Address - Phone:209-406-8497
Practice Address - Fax:209-910-9864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43057101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty