Provider Demographics
NPI:1710168158
Name:HUMAN SERVICES PROJECTS, INC.
Entity Type:Organization
Organization Name:HUMAN SERVICES PROJECTS, INC.
Other - Org Name:COMMUNITY BEHAVIORAL INTERVENTION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTI
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:FREDERICKS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:209-477-9177
Mailing Address - Street 1:5361 N PERSHING AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-5450
Mailing Address - Country:US
Mailing Address - Phone:209-477-9177
Mailing Address - Fax:209-477-4667
Practice Address - Street 1:5361 N PERSHING AVE
Practice Address - Street 2:SUITE H
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-5450
Practice Address - Country:US
Practice Address - Phone:209-477-9177
Practice Address - Fax:209-477-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM13967251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health