Provider Demographics
NPI:1578623963
Name:VALLEY HEALTH TEAM INC
Entity Type:Organization
Organization Name:VALLEY HEALTH TEAM INC
Other - Org Name:SAN JOAQUIN HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:DISNEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:559-693-2462
Mailing Address - Street 1:PO BOX 737
Mailing Address - Street 2:21890 COLORADO AVENUE
Mailing Address - City:SAN JOAQUIN
Mailing Address - State:CA
Mailing Address - Zip Code:93660-0737
Mailing Address - Country:US
Mailing Address - Phone:559-693-2462
Mailing Address - Fax:559-693-4382
Practice Address - Street 1:21890 COLORADO AVENUE
Practice Address - Street 2:
Practice Address - City:SAN JOAQUIN
Practice Address - State:CA
Practice Address - Zip Code:93660-0737
Practice Address - Country:US
Practice Address - Phone:559-693-2462
Practice Address - Fax:559-693-4382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty
Not Answered363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC03875FMedicaid
CAFHC03875FMedicaid
CA051937Medicare ID - Type Unspecified