Provider Demographics
NPI:1598953085
Name:SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-468-3429
Mailing Address - Street 1:600 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202-3029
Mailing Address - Country:US
Mailing Address - Phone:209-468-3447
Mailing Address - Fax:209-464-0138
Practice Address - Street 1:600 E MAIN ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-3029
Practice Address - Country:US
Practice Address - Phone:209-468-3447
Practice Address - Fax:209-464-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare