san joaquin county behavioral health services county and … english medi-cal provider... ·...
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San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
1 Black Awareness
Community Outreach
ProgramMulticultural
Services
(BACOPMC) - Full
Service Partnership
(MHSA)
9090
1149 N El Dorado
Street
Stockton CA 95202
(209) 468-2337
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Hindi
Punjabi
Urdu
Pushto
English
Spanish
Full Service Partnership
with a special emphasis on
outreach to the African
American Native
American MuslimMiddle
Eastern and
GayLesbianBisexualTra
nsgender communities
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
2 Children and
Youth Services
Stockton Clinic (CYS)
3915
1414 N California
Street
Stockton CA 95202
(209) 468-2385
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Russian
Ukranian
Hindi Urdu
Comprehensive mental
health services for
children youth and their
families living in Central
County area Services
include individual and
group therapy case
management psychiatric
assessment and
medication support
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
COUNTY OWNED amp OPERATED PROGRAMS (24 hours a day 7 days a week toll-free telephone number 1-888-468-9370)
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 1 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
3 Children and
Youth Services -
Foster Youth Full
Service Partnership
(MHSA)
9096
1414 N California
Street
Stockton CA 95202
(209) 468-2385
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Tagalog
Urdu
Punjabi
Hindi
Mental Health Services
Act (MHSA) program
focused on children and
youth in the Foster Care
system
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
4 Children and
Youth Services -
Juvenile Justice Full
Service Partnership
(MHSA)
9095+A9
1414 N California
Street
Stockton CA 95202
(209) 468-2385
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Cambodian
Spanish
Hmong
Mental Health Services
Act program focused on
children and youth in the
Juvenile Justice system
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 2 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
5 Community Adult
Treatment Services
(CATS - Teams A B
C and D)
9069
1212 N California
Street
Stockton CA 95202
(209) 468-8842
(209) 468-8862
(209) 468-8881
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Spanish
Cantonese
Tagalog
Comprehensive Mental
Health Services for adults
(18-60) Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
6 Community
Corrections
Partnership
9039AP
1212 N California
Street
Stockton CA 95202
(209) 468-9373
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Serve clients under AB-
109 community
supervision with Probation
to reduce recidivism
promote wellness and
recovery and increase
safety for our community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 3 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
7 Crisis Community
Response Team
(CCRT)
9088
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
Crisis Community
Response Team
(CCRT)Mobile Crisis
Support Team (MCST)
12-830 pm 7 days a
week
Adult
Children
Youth
Older Adult
Spanish
Mobile multi-disciplinary
crisis team for community
adult mental health
outreach early
intervention and joint field
response with law
enforcement for crisis
5150 detention
evaluations
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
8 Crisis Intervention
Services
9011
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult
Children
Youth Older
Adult
Spanish
24-Hour evaluation
services including
assessment for psychiatric
emergencies crisis
counseling outpatient and
community referrals
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
9 Crisis Stabilization
Units (CSU)
9032
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult
Adolescents
Older Adult
Spanish
Cambodian
Vietnamese
23-Hour psychiatric
assessment and
stabilization unit
Resources and Referrals
are provided during
admission
Crisis Stabilization UC Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 4 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
10 Forensic Court
Full Service
Partnership (MHSA)
9091
1212 N California
Street Stockton CA
95202
(209) 468-8786
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Provides comprehensive
psychiatric and integrative
services to address the
needs of Mentally Ill
Offenders
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
11 Gaining Older
Adult Life Skills
(GOALS) Full
Service Partnership
(MHSA)
9093
1212 N California
Street
Stockton CA 95202
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult Spanish
Full Service Partnership
with the emphasis on
outreach to the
underserved older adult
population ages (60+)
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 5 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
12 InSPIRE
(MHSA)
39AN
1212 N California
Street
Stockton CA 95202
(209) 468-8880
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Spanish
Cambodian
Vietnamese
MHSA innovation
component providing
learning community
opportunities to
specialized cohorts
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
13 La Familia Clinic
Full Service
Partnership (MHSA)
9092
1149 N El Dorado
Street
Stockton CA 95202
(209) 468-2335
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Focus on
Latino
outreach and
access
Spanish
Psychiatric assessment
case management
medication support
individual and group
therapy with a special
emphasis on serving
Spanish-speaking persons
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 6 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
14 Mary Graham
Childrens Shelter
9008
6861 Mary Graham
Lane
French Camp CA
95231
(209) 468-6966
httpwww
marygrahamfoundationorg
24 hours
Children and
Youth
Provides outpatient mental
health services to residents
of Mary Graham
Childrens Shelter
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
15 MHSA TAY FSP
39B1
1212 N California
Street Stockton CA
95202
(209) 468-8862
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adults
Full service partnership
providing outpatient
mental health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 7 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
16 Older Adult
Services (OAS)
3980
1212 N California
Street
Stockton CA
95202+B8
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult
Spanish
Cambodian
Vietnamese
Comprehensive Behavioral
Health Services for older
adults (60+) provided by a
multidisciplinary team
Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
17 Peterson Hall
9009
535 W Matthews Rd
French Camp CA
95231
(209) 468-4240
hiipswwwsjgovorgmhs
M-F 8 am- 8 pm
SatSun 10 am -7 pm
Children and
Youth
Cambodian
Spanish
Provides outpatient mental
health services to youth
detained at Peterson Hall
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
18 Psychiatric
Health Facility (PHF)
3976
1212 N California
Street Stockton CA
95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult Spanish24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 8 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
19 San Joaquin
County MH Services
Lodi Clinic
3924
1209 W Tokay
Street
Suites 1 3 5 7 9
12 14 and 16
Lodi CA 95240
(209) 331-2070
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Children
Youth
Spanish
Comprehensive mental
health services for adults
(18-60) living in North
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
20 San Joaquin
County MH Services
Tracy Clinic
9048
220 W Eleventh
Street
Tracy CA 95376
(209) 831-5941
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Comprehensive mental
health services for adults
(18-60) living in South
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 9 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
21 SJC-MHS CYS
Katie A Services
9020
333 E Washington
Street
Stockton CA 95202
(209) 468-1547
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Hmong
Japanese
Provides in-home and in-
community outpatient
mental health services to
WampI Code 300 dependent
SJC children
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
22 Transcultural
Clinic (TCC) - full
range of specialty
mental health services
and intensive case
management program
9014
4422 N Pershing
Ave
Suites D1-D4
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 10 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
3 Children and
Youth Services -
Foster Youth Full
Service Partnership
(MHSA)
9096
1414 N California
Street
Stockton CA 95202
(209) 468-2385
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Tagalog
Urdu
Punjabi
Hindi
Mental Health Services
Act (MHSA) program
focused on children and
youth in the Foster Care
system
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
4 Children and
Youth Services -
Juvenile Justice Full
Service Partnership
(MHSA)
9095+A9
1414 N California
Street
Stockton CA 95202
(209) 468-2385
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Cambodian
Spanish
Hmong
Mental Health Services
Act program focused on
children and youth in the
Juvenile Justice system
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 2 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
5 Community Adult
Treatment Services
(CATS - Teams A B
C and D)
9069
1212 N California
Street
Stockton CA 95202
(209) 468-8842
(209) 468-8862
(209) 468-8881
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Spanish
Cantonese
Tagalog
Comprehensive Mental
Health Services for adults
(18-60) Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
6 Community
Corrections
Partnership
9039AP
1212 N California
Street
Stockton CA 95202
(209) 468-9373
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Serve clients under AB-
109 community
supervision with Probation
to reduce recidivism
promote wellness and
recovery and increase
safety for our community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 3 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
7 Crisis Community
Response Team
(CCRT)
9088
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
Crisis Community
Response Team
(CCRT)Mobile Crisis
Support Team (MCST)
12-830 pm 7 days a
week
Adult
Children
Youth
Older Adult
Spanish
Mobile multi-disciplinary
crisis team for community
adult mental health
outreach early
intervention and joint field
response with law
enforcement for crisis
5150 detention
evaluations
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
8 Crisis Intervention
Services
9011
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult
Children
Youth Older
Adult
Spanish
24-Hour evaluation
services including
assessment for psychiatric
emergencies crisis
counseling outpatient and
community referrals
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
9 Crisis Stabilization
Units (CSU)
9032
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult
Adolescents
Older Adult
Spanish
Cambodian
Vietnamese
23-Hour psychiatric
assessment and
stabilization unit
Resources and Referrals
are provided during
admission
Crisis Stabilization UC Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 4 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
10 Forensic Court
Full Service
Partnership (MHSA)
9091
1212 N California
Street Stockton CA
95202
(209) 468-8786
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Provides comprehensive
psychiatric and integrative
services to address the
needs of Mentally Ill
Offenders
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
11 Gaining Older
Adult Life Skills
(GOALS) Full
Service Partnership
(MHSA)
9093
1212 N California
Street
Stockton CA 95202
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult Spanish
Full Service Partnership
with the emphasis on
outreach to the
underserved older adult
population ages (60+)
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 5 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
12 InSPIRE
(MHSA)
39AN
1212 N California
Street
Stockton CA 95202
(209) 468-8880
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Spanish
Cambodian
Vietnamese
MHSA innovation
component providing
learning community
opportunities to
specialized cohorts
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
13 La Familia Clinic
Full Service
Partnership (MHSA)
9092
1149 N El Dorado
Street
Stockton CA 95202
(209) 468-2335
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Focus on
Latino
outreach and
access
Spanish
Psychiatric assessment
case management
medication support
individual and group
therapy with a special
emphasis on serving
Spanish-speaking persons
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 6 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
14 Mary Graham
Childrens Shelter
9008
6861 Mary Graham
Lane
French Camp CA
95231
(209) 468-6966
httpwww
marygrahamfoundationorg
24 hours
Children and
Youth
Provides outpatient mental
health services to residents
of Mary Graham
Childrens Shelter
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
15 MHSA TAY FSP
39B1
1212 N California
Street Stockton CA
95202
(209) 468-8862
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adults
Full service partnership
providing outpatient
mental health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 7 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
16 Older Adult
Services (OAS)
3980
1212 N California
Street
Stockton CA
95202+B8
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult
Spanish
Cambodian
Vietnamese
Comprehensive Behavioral
Health Services for older
adults (60+) provided by a
multidisciplinary team
Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
17 Peterson Hall
9009
535 W Matthews Rd
French Camp CA
95231
(209) 468-4240
hiipswwwsjgovorgmhs
M-F 8 am- 8 pm
SatSun 10 am -7 pm
Children and
Youth
Cambodian
Spanish
Provides outpatient mental
health services to youth
detained at Peterson Hall
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
18 Psychiatric
Health Facility (PHF)
3976
1212 N California
Street Stockton CA
95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult Spanish24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 8 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
19 San Joaquin
County MH Services
Lodi Clinic
3924
1209 W Tokay
Street
Suites 1 3 5 7 9
12 14 and 16
Lodi CA 95240
(209) 331-2070
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Children
Youth
Spanish
Comprehensive mental
health services for adults
(18-60) living in North
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
20 San Joaquin
County MH Services
Tracy Clinic
9048
220 W Eleventh
Street
Tracy CA 95376
(209) 831-5941
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Comprehensive mental
health services for adults
(18-60) living in South
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 9 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
21 SJC-MHS CYS
Katie A Services
9020
333 E Washington
Street
Stockton CA 95202
(209) 468-1547
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Hmong
Japanese
Provides in-home and in-
community outpatient
mental health services to
WampI Code 300 dependent
SJC children
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
22 Transcultural
Clinic (TCC) - full
range of specialty
mental health services
and intensive case
management program
9014
4422 N Pershing
Ave
Suites D1-D4
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 10 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
5 Community Adult
Treatment Services
(CATS - Teams A B
C and D)
9069
1212 N California
Street
Stockton CA 95202
(209) 468-8842
(209) 468-8862
(209) 468-8881
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Spanish
Cantonese
Tagalog
Comprehensive Mental
Health Services for adults
(18-60) Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
6 Community
Corrections
Partnership
9039AP
1212 N California
Street
Stockton CA 95202
(209) 468-9373
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Serve clients under AB-
109 community
supervision with Probation
to reduce recidivism
promote wellness and
recovery and increase
safety for our community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 3 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
7 Crisis Community
Response Team
(CCRT)
9088
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
Crisis Community
Response Team
(CCRT)Mobile Crisis
Support Team (MCST)
12-830 pm 7 days a
week
Adult
Children
Youth
Older Adult
Spanish
Mobile multi-disciplinary
crisis team for community
adult mental health
outreach early
intervention and joint field
response with law
enforcement for crisis
5150 detention
evaluations
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
8 Crisis Intervention
Services
9011
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult
Children
Youth Older
Adult
Spanish
24-Hour evaluation
services including
assessment for psychiatric
emergencies crisis
counseling outpatient and
community referrals
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
9 Crisis Stabilization
Units (CSU)
9032
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult
Adolescents
Older Adult
Spanish
Cambodian
Vietnamese
23-Hour psychiatric
assessment and
stabilization unit
Resources and Referrals
are provided during
admission
Crisis Stabilization UC Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 4 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
10 Forensic Court
Full Service
Partnership (MHSA)
9091
1212 N California
Street Stockton CA
95202
(209) 468-8786
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Provides comprehensive
psychiatric and integrative
services to address the
needs of Mentally Ill
Offenders
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
11 Gaining Older
Adult Life Skills
(GOALS) Full
Service Partnership
(MHSA)
9093
1212 N California
Street
Stockton CA 95202
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult Spanish
Full Service Partnership
with the emphasis on
outreach to the
underserved older adult
population ages (60+)
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 5 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
12 InSPIRE
(MHSA)
39AN
1212 N California
Street
Stockton CA 95202
(209) 468-8880
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Spanish
Cambodian
Vietnamese
MHSA innovation
component providing
learning community
opportunities to
specialized cohorts
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
13 La Familia Clinic
Full Service
Partnership (MHSA)
9092
1149 N El Dorado
Street
Stockton CA 95202
(209) 468-2335
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Focus on
Latino
outreach and
access
Spanish
Psychiatric assessment
case management
medication support
individual and group
therapy with a special
emphasis on serving
Spanish-speaking persons
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 6 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
14 Mary Graham
Childrens Shelter
9008
6861 Mary Graham
Lane
French Camp CA
95231
(209) 468-6966
httpwww
marygrahamfoundationorg
24 hours
Children and
Youth
Provides outpatient mental
health services to residents
of Mary Graham
Childrens Shelter
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
15 MHSA TAY FSP
39B1
1212 N California
Street Stockton CA
95202
(209) 468-8862
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adults
Full service partnership
providing outpatient
mental health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 7 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
16 Older Adult
Services (OAS)
3980
1212 N California
Street
Stockton CA
95202+B8
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult
Spanish
Cambodian
Vietnamese
Comprehensive Behavioral
Health Services for older
adults (60+) provided by a
multidisciplinary team
Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
17 Peterson Hall
9009
535 W Matthews Rd
French Camp CA
95231
(209) 468-4240
hiipswwwsjgovorgmhs
M-F 8 am- 8 pm
SatSun 10 am -7 pm
Children and
Youth
Cambodian
Spanish
Provides outpatient mental
health services to youth
detained at Peterson Hall
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
18 Psychiatric
Health Facility (PHF)
3976
1212 N California
Street Stockton CA
95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult Spanish24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 8 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
19 San Joaquin
County MH Services
Lodi Clinic
3924
1209 W Tokay
Street
Suites 1 3 5 7 9
12 14 and 16
Lodi CA 95240
(209) 331-2070
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Children
Youth
Spanish
Comprehensive mental
health services for adults
(18-60) living in North
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
20 San Joaquin
County MH Services
Tracy Clinic
9048
220 W Eleventh
Street
Tracy CA 95376
(209) 831-5941
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Comprehensive mental
health services for adults
(18-60) living in South
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 9 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
21 SJC-MHS CYS
Katie A Services
9020
333 E Washington
Street
Stockton CA 95202
(209) 468-1547
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Hmong
Japanese
Provides in-home and in-
community outpatient
mental health services to
WampI Code 300 dependent
SJC children
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
22 Transcultural
Clinic (TCC) - full
range of specialty
mental health services
and intensive case
management program
9014
4422 N Pershing
Ave
Suites D1-D4
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 10 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
7 Crisis Community
Response Team
(CCRT)
9088
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
Crisis Community
Response Team
(CCRT)Mobile Crisis
Support Team (MCST)
12-830 pm 7 days a
week
Adult
Children
Youth
Older Adult
Spanish
Mobile multi-disciplinary
crisis team for community
adult mental health
outreach early
intervention and joint field
response with law
enforcement for crisis
5150 detention
evaluations
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
8 Crisis Intervention
Services
9011
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult
Children
Youth Older
Adult
Spanish
24-Hour evaluation
services including
assessment for psychiatric
emergencies crisis
counseling outpatient and
community referrals
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
9 Crisis Stabilization
Units (CSU)
9032
1212 N California
Street
Stockton CA 95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult
Adolescents
Older Adult
Spanish
Cambodian
Vietnamese
23-Hour psychiatric
assessment and
stabilization unit
Resources and Referrals
are provided during
admission
Crisis Stabilization UC Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 4 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
10 Forensic Court
Full Service
Partnership (MHSA)
9091
1212 N California
Street Stockton CA
95202
(209) 468-8786
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Provides comprehensive
psychiatric and integrative
services to address the
needs of Mentally Ill
Offenders
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
11 Gaining Older
Adult Life Skills
(GOALS) Full
Service Partnership
(MHSA)
9093
1212 N California
Street
Stockton CA 95202
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult Spanish
Full Service Partnership
with the emphasis on
outreach to the
underserved older adult
population ages (60+)
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 5 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
12 InSPIRE
(MHSA)
39AN
1212 N California
Street
Stockton CA 95202
(209) 468-8880
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Spanish
Cambodian
Vietnamese
MHSA innovation
component providing
learning community
opportunities to
specialized cohorts
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
13 La Familia Clinic
Full Service
Partnership (MHSA)
9092
1149 N El Dorado
Street
Stockton CA 95202
(209) 468-2335
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Focus on
Latino
outreach and
access
Spanish
Psychiatric assessment
case management
medication support
individual and group
therapy with a special
emphasis on serving
Spanish-speaking persons
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 6 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
14 Mary Graham
Childrens Shelter
9008
6861 Mary Graham
Lane
French Camp CA
95231
(209) 468-6966
httpwww
marygrahamfoundationorg
24 hours
Children and
Youth
Provides outpatient mental
health services to residents
of Mary Graham
Childrens Shelter
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
15 MHSA TAY FSP
39B1
1212 N California
Street Stockton CA
95202
(209) 468-8862
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adults
Full service partnership
providing outpatient
mental health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 7 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
16 Older Adult
Services (OAS)
3980
1212 N California
Street
Stockton CA
95202+B8
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult
Spanish
Cambodian
Vietnamese
Comprehensive Behavioral
Health Services for older
adults (60+) provided by a
multidisciplinary team
Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
17 Peterson Hall
9009
535 W Matthews Rd
French Camp CA
95231
(209) 468-4240
hiipswwwsjgovorgmhs
M-F 8 am- 8 pm
SatSun 10 am -7 pm
Children and
Youth
Cambodian
Spanish
Provides outpatient mental
health services to youth
detained at Peterson Hall
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
18 Psychiatric
Health Facility (PHF)
3976
1212 N California
Street Stockton CA
95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult Spanish24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 8 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
19 San Joaquin
County MH Services
Lodi Clinic
3924
1209 W Tokay
Street
Suites 1 3 5 7 9
12 14 and 16
Lodi CA 95240
(209) 331-2070
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Children
Youth
Spanish
Comprehensive mental
health services for adults
(18-60) living in North
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
20 San Joaquin
County MH Services
Tracy Clinic
9048
220 W Eleventh
Street
Tracy CA 95376
(209) 831-5941
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Comprehensive mental
health services for adults
(18-60) living in South
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 9 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
21 SJC-MHS CYS
Katie A Services
9020
333 E Washington
Street
Stockton CA 95202
(209) 468-1547
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Hmong
Japanese
Provides in-home and in-
community outpatient
mental health services to
WampI Code 300 dependent
SJC children
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
22 Transcultural
Clinic (TCC) - full
range of specialty
mental health services
and intensive case
management program
9014
4422 N Pershing
Ave
Suites D1-D4
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 10 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
10 Forensic Court
Full Service
Partnership (MHSA)
9091
1212 N California
Street Stockton CA
95202
(209) 468-8786
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Provides comprehensive
psychiatric and integrative
services to address the
needs of Mentally Ill
Offenders
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
11 Gaining Older
Adult Life Skills
(GOALS) Full
Service Partnership
(MHSA)
9093
1212 N California
Street
Stockton CA 95202
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult Spanish
Full Service Partnership
with the emphasis on
outreach to the
underserved older adult
population ages (60+)
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 5 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
12 InSPIRE
(MHSA)
39AN
1212 N California
Street
Stockton CA 95202
(209) 468-8880
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Spanish
Cambodian
Vietnamese
MHSA innovation
component providing
learning community
opportunities to
specialized cohorts
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
13 La Familia Clinic
Full Service
Partnership (MHSA)
9092
1149 N El Dorado
Street
Stockton CA 95202
(209) 468-2335
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Focus on
Latino
outreach and
access
Spanish
Psychiatric assessment
case management
medication support
individual and group
therapy with a special
emphasis on serving
Spanish-speaking persons
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 6 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
14 Mary Graham
Childrens Shelter
9008
6861 Mary Graham
Lane
French Camp CA
95231
(209) 468-6966
httpwww
marygrahamfoundationorg
24 hours
Children and
Youth
Provides outpatient mental
health services to residents
of Mary Graham
Childrens Shelter
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
15 MHSA TAY FSP
39B1
1212 N California
Street Stockton CA
95202
(209) 468-8862
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adults
Full service partnership
providing outpatient
mental health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 7 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
16 Older Adult
Services (OAS)
3980
1212 N California
Street
Stockton CA
95202+B8
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult
Spanish
Cambodian
Vietnamese
Comprehensive Behavioral
Health Services for older
adults (60+) provided by a
multidisciplinary team
Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
17 Peterson Hall
9009
535 W Matthews Rd
French Camp CA
95231
(209) 468-4240
hiipswwwsjgovorgmhs
M-F 8 am- 8 pm
SatSun 10 am -7 pm
Children and
Youth
Cambodian
Spanish
Provides outpatient mental
health services to youth
detained at Peterson Hall
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
18 Psychiatric
Health Facility (PHF)
3976
1212 N California
Street Stockton CA
95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult Spanish24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 8 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
19 San Joaquin
County MH Services
Lodi Clinic
3924
1209 W Tokay
Street
Suites 1 3 5 7 9
12 14 and 16
Lodi CA 95240
(209) 331-2070
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Children
Youth
Spanish
Comprehensive mental
health services for adults
(18-60) living in North
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
20 San Joaquin
County MH Services
Tracy Clinic
9048
220 W Eleventh
Street
Tracy CA 95376
(209) 831-5941
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Comprehensive mental
health services for adults
(18-60) living in South
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 9 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
21 SJC-MHS CYS
Katie A Services
9020
333 E Washington
Street
Stockton CA 95202
(209) 468-1547
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Hmong
Japanese
Provides in-home and in-
community outpatient
mental health services to
WampI Code 300 dependent
SJC children
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
22 Transcultural
Clinic (TCC) - full
range of specialty
mental health services
and intensive case
management program
9014
4422 N Pershing
Ave
Suites D1-D4
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 10 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
12 InSPIRE
(MHSA)
39AN
1212 N California
Street
Stockton CA 95202
(209) 468-8880
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Spanish
Cambodian
Vietnamese
MHSA innovation
component providing
learning community
opportunities to
specialized cohorts
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
13 La Familia Clinic
Full Service
Partnership (MHSA)
9092
1149 N El Dorado
Street
Stockton CA 95202
(209) 468-2335
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Focus on
Latino
outreach and
access
Spanish
Psychiatric assessment
case management
medication support
individual and group
therapy with a special
emphasis on serving
Spanish-speaking persons
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 6 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
14 Mary Graham
Childrens Shelter
9008
6861 Mary Graham
Lane
French Camp CA
95231
(209) 468-6966
httpwww
marygrahamfoundationorg
24 hours
Children and
Youth
Provides outpatient mental
health services to residents
of Mary Graham
Childrens Shelter
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
15 MHSA TAY FSP
39B1
1212 N California
Street Stockton CA
95202
(209) 468-8862
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adults
Full service partnership
providing outpatient
mental health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 7 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
16 Older Adult
Services (OAS)
3980
1212 N California
Street
Stockton CA
95202+B8
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult
Spanish
Cambodian
Vietnamese
Comprehensive Behavioral
Health Services for older
adults (60+) provided by a
multidisciplinary team
Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
17 Peterson Hall
9009
535 W Matthews Rd
French Camp CA
95231
(209) 468-4240
hiipswwwsjgovorgmhs
M-F 8 am- 8 pm
SatSun 10 am -7 pm
Children and
Youth
Cambodian
Spanish
Provides outpatient mental
health services to youth
detained at Peterson Hall
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
18 Psychiatric
Health Facility (PHF)
3976
1212 N California
Street Stockton CA
95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult Spanish24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 8 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
19 San Joaquin
County MH Services
Lodi Clinic
3924
1209 W Tokay
Street
Suites 1 3 5 7 9
12 14 and 16
Lodi CA 95240
(209) 331-2070
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Children
Youth
Spanish
Comprehensive mental
health services for adults
(18-60) living in North
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
20 San Joaquin
County MH Services
Tracy Clinic
9048
220 W Eleventh
Street
Tracy CA 95376
(209) 831-5941
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Comprehensive mental
health services for adults
(18-60) living in South
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 9 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
21 SJC-MHS CYS
Katie A Services
9020
333 E Washington
Street
Stockton CA 95202
(209) 468-1547
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Hmong
Japanese
Provides in-home and in-
community outpatient
mental health services to
WampI Code 300 dependent
SJC children
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
22 Transcultural
Clinic (TCC) - full
range of specialty
mental health services
and intensive case
management program
9014
4422 N Pershing
Ave
Suites D1-D4
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 10 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
14 Mary Graham
Childrens Shelter
9008
6861 Mary Graham
Lane
French Camp CA
95231
(209) 468-6966
httpwww
marygrahamfoundationorg
24 hours
Children and
Youth
Provides outpatient mental
health services to residents
of Mary Graham
Childrens Shelter
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
15 MHSA TAY FSP
39B1
1212 N California
Street Stockton CA
95202
(209) 468-8862
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adults
Full service partnership
providing outpatient
mental health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 7 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
16 Older Adult
Services (OAS)
3980
1212 N California
Street
Stockton CA
95202+B8
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult
Spanish
Cambodian
Vietnamese
Comprehensive Behavioral
Health Services for older
adults (60+) provided by a
multidisciplinary team
Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
17 Peterson Hall
9009
535 W Matthews Rd
French Camp CA
95231
(209) 468-4240
hiipswwwsjgovorgmhs
M-F 8 am- 8 pm
SatSun 10 am -7 pm
Children and
Youth
Cambodian
Spanish
Provides outpatient mental
health services to youth
detained at Peterson Hall
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
18 Psychiatric
Health Facility (PHF)
3976
1212 N California
Street Stockton CA
95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult Spanish24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 8 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
19 San Joaquin
County MH Services
Lodi Clinic
3924
1209 W Tokay
Street
Suites 1 3 5 7 9
12 14 and 16
Lodi CA 95240
(209) 331-2070
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Children
Youth
Spanish
Comprehensive mental
health services for adults
(18-60) living in North
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
20 San Joaquin
County MH Services
Tracy Clinic
9048
220 W Eleventh
Street
Tracy CA 95376
(209) 831-5941
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Comprehensive mental
health services for adults
(18-60) living in South
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 9 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
21 SJC-MHS CYS
Katie A Services
9020
333 E Washington
Street
Stockton CA 95202
(209) 468-1547
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Hmong
Japanese
Provides in-home and in-
community outpatient
mental health services to
WampI Code 300 dependent
SJC children
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
22 Transcultural
Clinic (TCC) - full
range of specialty
mental health services
and intensive case
management program
9014
4422 N Pershing
Ave
Suites D1-D4
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 10 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
16 Older Adult
Services (OAS)
3980
1212 N California
Street
Stockton CA
95202+B8
(209) 468-3760
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Older Adult
Spanish
Cambodian
Vietnamese
Comprehensive Behavioral
Health Services for older
adults (60+) provided by a
multidisciplinary team
Services include
psychiatric assessment
medication support group
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
17 Peterson Hall
9009
535 W Matthews Rd
French Camp CA
95231
(209) 468-4240
hiipswwwsjgovorgmhs
M-F 8 am- 8 pm
SatSun 10 am -7 pm
Children and
Youth
Cambodian
Spanish
Provides outpatient mental
health services to youth
detained at Peterson Hall
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
18 Psychiatric
Health Facility (PHF)
3976
1212 N California
Street Stockton CA
95202
(209) 468-8686
httpswwwsjgovorgmhs
24 hours
Adult Spanish24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 8 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
19 San Joaquin
County MH Services
Lodi Clinic
3924
1209 W Tokay
Street
Suites 1 3 5 7 9
12 14 and 16
Lodi CA 95240
(209) 331-2070
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Children
Youth
Spanish
Comprehensive mental
health services for adults
(18-60) living in North
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
20 San Joaquin
County MH Services
Tracy Clinic
9048
220 W Eleventh
Street
Tracy CA 95376
(209) 831-5941
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Comprehensive mental
health services for adults
(18-60) living in South
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 9 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
21 SJC-MHS CYS
Katie A Services
9020
333 E Washington
Street
Stockton CA 95202
(209) 468-1547
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Hmong
Japanese
Provides in-home and in-
community outpatient
mental health services to
WampI Code 300 dependent
SJC children
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
22 Transcultural
Clinic (TCC) - full
range of specialty
mental health services
and intensive case
management program
9014
4422 N Pershing
Ave
Suites D1-D4
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 10 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
19 San Joaquin
County MH Services
Lodi Clinic
3924
1209 W Tokay
Street
Suites 1 3 5 7 9
12 14 and 16
Lodi CA 95240
(209) 331-2070
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult
Children
Youth
Spanish
Comprehensive mental
health services for adults
(18-60) living in North
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
20 San Joaquin
County MH Services
Tracy Clinic
9048
220 W Eleventh
Street
Tracy CA 95376
(209) 831-5941
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Spanish
Comprehensive mental
health services for adults
(18-60) living in South
County area Services
include psychiatric
assessment medication
support group and
individual therapy and
case management
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 9 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
21 SJC-MHS CYS
Katie A Services
9020
333 E Washington
Street
Stockton CA 95202
(209) 468-1547
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Hmong
Japanese
Provides in-home and in-
community outpatient
mental health services to
WampI Code 300 dependent
SJC children
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
22 Transcultural
Clinic (TCC) - full
range of specialty
mental health services
and intensive case
management program
9014
4422 N Pershing
Ave
Suites D1-D4
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 10 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
21 SJC-MHS CYS
Katie A Services
9020
333 E Washington
Street
Stockton CA 95202
(209) 468-1547
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Children and
Youth
Spanish
Hmong
Japanese
Provides in-home and in-
community outpatient
mental health services to
WampI Code 300 dependent
SJC children
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
22 Transcultural
Clinic (TCC) - full
range of specialty
mental health services
and intensive case
management program
9014
4422 N Pershing
Ave
Suites D1-D4
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 10 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
23 Southeast Asian
Recovery Services
(SEARS) for the
Southeast Asian
population-Full
Service Partnership
(MHSA)
9094
4422 N Pershing
Avenue Suite D2
D3 D4 D5 D6
Stockton CA 95207
(209) 953-8843
httpswwwsjgovorgmhs
M-F 8 am- 5 pm
Adult Focus
on outreach
and access
for the
Southeast
Asian
population
Cambodian
Laotian
Hmong
Vietnamese
Thai
Full Service Partnership
with emphasis on serving
persons from Southeast
Asia Services available in
Cambodian (Khmer)
Hmong Laotian (Lao) and
Vietnamese
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
25 ASPIRAnet
39AR
6 S El Dorado Street
Suite 510 Stockton
CA 95202
(209) 478-9862
wwwaspiranetorg
M-F 8 am- 5 pm
Children and
Youth
Provides Therapeutic
Behavioral Services (TBS)
and crisis stabilization
services as an alternative
to psychiatric
hospitalization
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
458 Almond Drive
Lodi CA 95240
24 Anka Lodi (was
Mourfield House) YesYesYes
Crisis Residential
Treatment ProgramAdult
(209) 982-4697
wwwankabhiorg 24 hour
CONTRACT ORGANIZATIONAL PROVIDERS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 11 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
26 Bright House
9047
8210 Bright Road
French Camp CA
95231
(209) 982-1235
wwwankabhiorg
24 hours
Adult
Adult Transitional
Residential Treatment
Program
Medication Support Yes Yes Yes
27 Casa Pacifica
39AB
1722 S Lewis Road
Camarrillo CA
93012
(805) 981-1422
wwwcaspacificaorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
28 CBIS (University
of the Pacific)
39A1
405 E Pine Street
Stockton CA 95204
(209) 476-1959
wwwcommunityre-
entryprogramcom
M-F 8 am- 430 pm
Adult SpanishBehavioral Intervention
Services
Mental Health Services
Intensive Home Based
Services
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 12 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
29 Chamberlains
Children Center Inc
39B4
1850 San Benito
Street
Hollister CA 95023
(831) 636-2121
wwwchamberlainccorg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
30 Charis Youth
Center
9057
714 W Main Street
Grass Valley CA
95945
(530) 477-9800
wwwcharisyouthcenteror
g M-F 830 am- 430 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 13 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
31 Child Abuse
Prevention Council
39A8
540 N California
Street
Stockton CA 95202
(209) 644-5311
wwwnochildabuseorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services utilizing
strengthening family
approach
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
32 Community Re-
Entry Program (CRP)
9044
405 E Pine Street
Stockton CA 95204
(209) 946-2132
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides independent
living skills training and
rehabilitation services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
33 Crestwood
Solano (PHF)
39A8
2201 Tuolumne
Street Suite B
Vallejo CA 94589
(707) 558-1777
wwwcrestwoodbehavioral
healthcom
24 hours
Adult24-hour inpatient
hospitalization servicesYes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 14 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
34 Crittenton
Services For Children
And Families
39B3
100 E Valley View
Drive Fullerton CA
92832
(714) 680-9000
wwwcrittentonsocalorg
M-F 830 am- 5 pm
Children and
Youth
Residential facility
providing mental health
treatment to youth
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Medication
Support Crisis
Intervention
Yes Yes Yes
35 Edgewood Center
for Children and
Families
39AV
1801 Vincente Street
San Francisco CA
94116
(415) 681-3211
wwwedgewoodorg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 15 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
36 Fred Finch Youth
Center
39AY
3800 Coolidge
AvenueOakland CA
94602
(510) 482-2244
wwwfredfinchorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
BrokerageIntensive Care
Coordination (ICC) Mental
Health Services including
Intensive Home Based
Services (IHBS)
Therapeutic Behavioral
Services (TBS) Crisis
Intervention
Yes Yes Yes
37 Grant House
9064
1117 S Grant Street
Stockton CA 95206
(209) 461-6500
wwwankabhiorg
24 hours
AdultCrisis Residential
Treatment ProgramYes Yes Yes
38 Latino Behavioral
Health and Recovery
Services
9067
445 N San Joaquin
Street
Stockton CA 95202
(209) 444-8910
wwwelconcilioorg
M-F 8 am- 5 pm
Adult Spanish
Provides Culturally
Competent Services to
Latinos
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 16 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
39 Martin Gipson
Socialization Center
9043
405 E Pine Street
Stockton CA 95204
(209) 464-5519
wwwcommunityre-
entryprogramcom
M-F 8 am- 5 pm
Adult Spanish
Provides socialization
vocational and
educational opportunities
for Adult Mentally ill
consumers
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis
Intervention
Yes Yes Yes
40 Mountain Valley
Child and Family
Services Inc
9039
24077 Highway 49
Nevada City CA
95959
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Therapeutic
Behavioral Services (TBS)
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 17 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
41 Mountain Valley
Child and Family
Services Inc
39A4
7818 Bar Du Lane
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
42 Mountain Valley
Child and Family
Services Inc
39A3
6171 Bradshaw Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 18 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
43 Mountain Valley
Child and Family
Services Inc
39A2
9211 Gerber Rd
Sacramento CA
95829
(530) 265-9057
wwwmountainvalleyfamil
yorg M-F 8 am- 430 pm
Children and
Youth
Provides outpatient mental
health services and full-
day Day Treatment
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Day Treatment
Intensive Full Day
Medication Support Crisis
Intervention
Yes Yes Yes
44 Phoenix House of
Los Angeles Inc
39B6
1600 Eldrige
AvenueLake View
Terrace CA 91342
(818) 686-3000
wwwphoenixhouseorg
M-F 8 am- 530 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 19 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
45 Rebekah
Childrenrsquos Home
39AU
290 IOOF Avenue
Gilroy CA 95020
(408) 846-2100
wwwrcskidsorg
M-F 8 am- 5 pm
ChildrenProvides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
46 Sacramento
Childrens Home
9076
2750 Sutterville Road
Sacramento CA
95820
(916) 452-3981
wwwkidshomeorg
M-F 830 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 20 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
47 San Gabriel
Childrens Center Out
Patient
39B7
4740 N Grand
Avenue Covina CA
91724
(626) 859-2089
wwwsangabrielchildcom
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
48 Star View
Adolescent Center OP
39BB
4025 West 226th
Street
Torrance CA
90505
(310)373-4556
wwwstarsinccom
24 hours
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 21 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
49 Summitview
Child Treatment
Center
9061
670 Placerville Dr
2 Placerville CA
95667
(530) 644-2412
wwwsummitviewtreatmen
torg M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHSB) Medication
SupportCrisis Intervention
Yes Yes Yes
50 Telecare (aka
Jeremy House)
39AX
5634 Jeremy Way
Stockton CA 95212
(209) 888-4969
wwwtelecarecorpcom
24 hour
AdultCrisis Residential
Treatment ProgramYes Yes Yes
51 Telecare Early
Intervention Recovery
Services (TEIRS)
39B2
4545 Georgetown
Place Suite A3
Stockton CA 95207
(209) 715-3754
wwwtelecarecorpcom
M-F 8 am- 5 pm
Adult Spanish
Provides outpatient mental
health services for children
and adults
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 22 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
52 TLC Child and
Family Services
39A9
1800 Gravenstein
Hwy North Suite A
Sebastopol CA
95472
(707) 823-7300
httpwwwtlc4kidsorg
M-F 8 am- 430 pm
Children and
Youth
Community-based
program providing
outpatient mental health
services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
53 Valley
Community
Counseling Services
(VCCS) (Manteca)
9040
129 E Center Street
Suite 3 Manteca CA
95336
(209) 239-5553
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 23 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
54 Valley
Community
Counseling Services
(VCCS) (School
Based Program -
Stockton)
9042
6707 Embarcadero
Drive Suite A
Stockton CA 95219
(209) 956-4240
Website NA
M-F 8 am- 5 pm
Children and
Youth
Outpatient mental health
services provided at
various schools in
Stockton Manteca and
Lodi
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
55 Valley
Community
Counseling Services
(VCCS) (Tracy)
9041
19 East 6th Street
Tracy CA 95378
(209) 835-8583
Website NA
M-F 8 am- 5 pm
Children and
Youth
Full range specialty mental
health services for children
and youth in South County
area
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 24 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
56 Victor
Community Services
and Support Stockton
(VCSS)
9063
2495 W March Lane
Suite 125 Stockton
CA 25207
(209) 465-1080
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Provides outpatient mental
health services in-home
and in community
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
57 Victor Treatment
Center - Santa Rosa
9083
3164 Condo Court
Santa Rosa CA
95403
(707) 523-2334
wwwvictororg
M-F 810 am- 4 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 25 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
58 Victor Youth
Services (North Valley
Schools)
39AC
855 Canyon Road
Redding CA 96001
(530) 378-1855
wwwvictororg
M-F 8 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Medication
Support Crisis Intervention
Yes Yes Yes
59 Womens Center-
Family and Youth
Services
39B6
729 N California
Street Stockton CA
95202
(209) 929-6700
wwwwomenscenteryfsor
g M-F 830 am- 5 pm
Children and
Youth
Outpatient Mental Health
Services
Case Management
Brokerage including
Intensive Care Coordination
(ICC) Mental Health
Services including Intensive
Home Based Services
(IHBS) Crisis Intervention
Yes Yes Yes
60 BHC Heritage
Oaks Hospital
4250 Auburn
Boulevard
(916) 489-3336
wwwheritageoakshospital
com 24 hours
All ages Yes Yes Yes
CONTRACT PSYCHIATRIC HOSPITALS
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 26 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
61 BHC Sierra Vista
Hospital8001 Bruceville Road
(916) 423-2000
wwwsierravistahospitalco
m 24 hours
All ages Yes Yes Yes
62 St Helena
Hospital Center for
Behavioral Health
525 Oregon Street
(707) 648-2200
wwwadventisthealthorg
24 hours
All ages Yes Yes Yes
63 John Muir
Behavioral Health
Center
2740 Grant Street
(925) 680-6500
wwwjohnmuirhealthcom
24 hours
All ages Yes Yes Yes
64 Sutter Center for
Psychiatry
7700 Folsom
Boulevard
(916) 388-3045
wwwsuttermedicalcenter
org 24 hours
All ages Yes Yes Yes
65 Fremont Hospital 39001 Sundale Drive
(510)796-1100
wwwfremonthospitalco
m 24 hours
All ages Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 27 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
66 Central Intake
Unit
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-9600
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult SpanishMon-Fri 8am-5pm
Closed Holidays
Substance use Disorder
Assessment for Outpatient
amp Inpatient Services
Yes Yes Yes
67 Chemical
Dependency
Counseling Center
(CDCC)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-3720
Fax (209)468-9611
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Youth Adult
Perinatal
Spanish
Monl Wed and Fri
8am-5pm
Closed Holidays
Outpatient Tratment
Perinatal Component
Intensive Outpatient Youth
Services
Yes Yes Yes
68 Alcohol amp Drug
Alternative Program
(ADAP)
620 N Aurora St
Suite 1 Stockton CA
95202
(209)468-6840
Fax (209)468-8640
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish
Monl Wed and Fri
8am-5pm Tue
amp Thur 8am-
7pm Closed
Holidays
Outpatient Court
Monitoring EducationYes Yes Yes
69 Family Ties
500 W Hospital Rd
French Camp CA
95231
(209)468-6208
Fax (209)468-7032
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult and
Adult
Perinatal
Spanish 24 Hour Services
Inpatient Treatment
Perinatal Component
Assessments
Yes Yes Yes
70 Recovery House
500 W Hospital Rd
French Camp CA
95231
(209)468-6857
Fax (209)468-6739
httpwwwsjcbhsorgPro
gram_Locationsaspx
Adult Spanish 24 Hour ServicesInpatient Treatment
AssessmentsYes Yes Yes
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 28 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
71 Adolescent Co-
Occurring Treatment
Program (ACT)
Childrens Behavioral
Health Services
1414 N California
St 2nd Floor
Stockton CA 95202
(209)468-2385
Fax (209)468-8024
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Individual amp group
counseling and education in
conjunction with the
adolescents mental health
services a partnership with
Mental Health Services and
Substance Abuse Services
Yes Yes Yes
72 Prevention
Services
620 N Aurora St
Suite 6 Stockton CA
95202
(209)468-2005
Fax (209)468-2251
httpwwwsjcbhsorgPro
gram_Locationsaspx
Youth SpanishMon-Fri 8am-5pm
Closed Holidays
Youth Services Parenting
Students In Prevention (SIP)Yes Yes Yes
73 Aegis Treatment
Center
8626 N Lower
Sacramento Road
Suite 41 Stockton
CA 95209
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1230pm
Sat Sun and Holidays
6am-1030am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
74 5th Street
Medical Clinic
Stockton
1839 S El Dorado
St Stockton CA
95206
(209)478-2487
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 29 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
San Joaquin County Behavioral Health Services
County and Contract Medi-Cal Providers
Accepting
New
Clients
Completed
Cultural
Competency
Training
Accommo-
dations for
people with
Disabilities
YesNo YesNo YesNo
Provider Characteristics
Cultural Competency
Medi-Cal Certified
Service Categories
Telephone
Website Addresses
Hours of Operation
Providers
Provider NumbersAddress
Populations
Served
Non-English
Languages
(in addition
to free
Interpreter
Services)
Including
ASL
75 Aegis Treatment
Center Healthy
Connections
(California St)
Stockton
1947 N California
St Suites B and C
StocktonCA 95210
(209)463-0870
httpsaegistreatmentcente
rscomclinicaegis-
stockton-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
76 Healthy
Connections Lodi
Clinic
441 South Ham Lane
Suite A Lodi
CA 95242
(209)224-8490
httpsaegistreatmentcente
rscomclinicaegis-lodi-
california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
7am-12 noon
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
77 Manteca Healthy
Connections
Center Street
955 W Center St
Suites 12A amp 14
Manteca CA 95337
(209)239-9600
httpsaegistreatmentcente
rscomclinicaegis-
manteca-california
Adult and
Adult
Perinatal
Spanish
Mon- Fri 530am - 1pm
Sat Sun and Holidays
8am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
78 MedMark
Treatment Center
1111 N El Dorado
St Stockton CA
95202
(209)938-0228
httpmedmarkcommed
mark-treatment-centers-
stockton
Adult and
Adult
Perinatal
Spanish
Mon- Fri 5am - 1pm
Sat Sun and Holidays
7am-11 am
Medically Supervised
Methadone Maintenance
Detoxification (OTP)
Outpatient Treatment (OTP)
Medication Assisted
Treatment
Yes Yes Yes
See Provider Staff Listing
Non-English Languages as well as American Sign Language are available upon request
Page 30 of 30 SJCBHS Medi-Cal Provider Directory_Rev 32019
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Provider Name Facility NameID
Type of Practioner
(licensed amp Waivered)
National Provider
Identifier number California license number type of license
Cultural
Compete
nce
Training
(YN)
1 Black Awareness
Community Outreach
Program
Multicultural Services Amarpreet Singh BHS BACOPMC Psychiatrist (Locum) 1235182916 Physician and Surgeon N
Aravind Pai BHS BACOPMC Psychiatrist (Locum) 1629076088 Physician and Surgeon A30319 N
Donna Bickham BHS BACOPMC Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Donnelle Tamayo BHS BACOPMC Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS BACOPMC Staff Nurse III 1104375724 Registered Nurse 723203 Y
Kathleen Wilson-Parish BHS BACOPMC Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS BACOPMC MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Nancy Nelson BHS BACOPMC Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Paul Wallace BHS BACOPMC Chief Psychiatric Tech 1114044799 Licensed Psychiatric Technician PT26296 Y
Quynh-Chi Nguyen BHS BACOPMC Staff Nurse III 1417371014 Registered Nurse 845080 Y
Shirley Hollowell BHS BACOPMC Registered Nurse 1124143474 Registered Nurse 352081 Y
2 Children and Youth
Services Stockton Clinic Ganiya (Iyabo) Adediran Childrens and Youth Services- Stockton 3915 Waivered 1881148690 81666 AMFT Y
Benjamin Alban Childrens and Youth Services- Stockton 3915 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Stockton 3915 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Stockton 3915 Licensed 1821294455 105923 Psychiatrist Y
Valentin Avramov Childrens and Youth Services- Stockton 3915 Licensed 1053488767 109609 Psychiatrist Y
Kristina Birch Childrens and Youth Services- Stockton 3915 Waivered 1366874844 1809 APCC Y
Linda Brett Childrens and Youth Services- Stockton 3915 Licensed 1295853299 523914 RN Y
Donna Cassettari Childrens and Youth Services- Stockton 3915 Licensed 1497887699 43173 LMFT Y
Renessa Castaneda-Jensen Childrens and Youth Services- Stockton 3915 Licensed 1376664862 81528 LMFT Y
Jacqueline Coulter Childrens and Youth Services- Stockton 3915 Licensed 1720184765 41366LMFT Y
Courtney Flores Childrens and Youth Services- Stockton 3915 Licensed 1851437735 29811 LCSQW Y
Maria Garcia Childrens and Youth Services- Stockton 3915 Licensed 1235400557 80425 LCSW Y
Ikesha Goodwin Childrens and Youth Services- Stockton 3915 Waivered 1104279728 101632 IMF Y
Provider Staff Listing 03-2019
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Kelsey Guidicatti Childrens and Youth Services- Stockton 3915 Waivered 1245783687 93458 AMFT Y
Antonio Gutierrez Childrens and Youth Services- Stockton 3915 Licensed 1023473469 71535 LCSW Y
Victoria Hall Childrens and Youth Services- Stockton 3915 Licensed 1437464179 91065 LMFT Y
Nicole Hodgson Childrens and Youth Services- Stockton 3915 Licensed 1962727792 85491 LMFT Y
Hudson Mark Hudson Childrens and Youth Services- Stockton 3915 Licensed 1528190725 78609 LMFT Y
Shadai Lescale Huante Childrens and Youth Services- Stockton 3915 Waivered 1528340320 59764 ACSW Y
Genevieve Lisenbey Childrens and Youth Services- Stockton 3915 Waivered 1265698104 80465 AMFT Y
Sharon Lizotte Childrens and Youth Services- Stockton 3915 Waivered 1851820708 101863 AMFT Y
Angie Nicholas Childrens and Youth Services- Stockton 3915 Licensed 1679713796 52080 LMFT Y
Shiella Pablico Childrens and Youth Services- Stockton 3915 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Sheilena Payne Childrens and Youth Services- Stockton 3915 Licensed 1336437656 94571 LMFT N
Timothy Quinn Childrens and Youth Services- Stockton 3915 Waivered 1316322381 79556 Marriage amp Family Therapist Intern Y
Joann Rihad Childrens and Youth Services- Stockton 3915 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Childrens and Youth Services- Stockton 3915 Licensed 1366468555 C53401 Psychiatrist Y
Jacqueline Salgado Childrens and Youth Services- Stockton 3915 Licensed 1043661903 95452 Marriage amp Family Therapist Y
Kristen Schneider Childrens and Youth Services- Stockton 3915 Waivered 1578963591 72071 ACSW Y
Carla Simien Childrens and Youth Services- Stockton 3915 Licensed 1629564000 40771 Licensed Psychiatric Technician N
Tamra Smith Childrens and Youth Services- Stockton 3915 Licensed 1336267608 76975 LCSW Y
Maribel Vargas Childrens and Youth Services- Stockton 3915 Waivered 1821247149 35622 ACSW Y
J Watkins Childrens and Youth Services- Stockton 3915 Licensed 1043797871 4200 LPCC Y
Tamara Weber Childrens and Youth Services- Stockton 3915 Licensed 1992101497 105926 LMFT Y
Amanda Yocham Childrens and Youth Services- Stockton 3915 Licensed 1326103516 79068 LMFT Y
Nikki Young Childrens and Youth Services- Stockton 3915 Waivered 1841692159 88891 AMFT Y
3 Children and Youth
Services- Foster Youth
Full Service Partnership Benjamin Alban Childrens and Youth Services- Foster Youth 9096 Licensed 1932227295 26094 LCSW Y
Maria Garcia Childrens and Youth Services- Foster Youth 9096 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Foster Youth 9096 Licensed 1023473469 71535 LCSW Y
4 Children and Youth
Services- Juvenile
Justice Full Srvice
Partnership Benjamin Alban Childrens and Youth Services- Juvenile Justice 9095 Licensed 1932227295 26094 LCSW Y
Sailaja Allanki Childrens and Youth Services- Juvenile Justice 9095 Licensed 1306897723 138838 Psychiatrist Y
Shaukat Ansari Childrens and Youth Services- Juvenile Justice 9095 Licensed 1821294455 105923 Psychiatrist Y
Maria Garcia Childrens and Youth Services- Juvenile Justice 9095 Licensed 1235400557 80425 LCSW Y
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Antonio Gutierrez Childrens and Youth Services- Juvenile Justice 9095 Licensed 1023473469 71535 LCSW Y
Shabneet Hira Brar Childrens and Youth Services- Juvenile Justice 9095 Licensed 1851598452 A112447 Psychiatrist Y
Sheilena Payne Childrens and Youth Services- Juvenile Justice 9095 Licensed 1336437656 94571 LMFT N
5 Community Adult
Treatment Services Amanda Hurlock CATS OUTPATIENT 1836 Waivered 1205369899 AMFT 100834 Y
Adeline Mendez CATS OUTPATIENT 1836 Licensed 1255453353 PT 25868 Y
Anna Perez Testo CATS OUTPATIENT 1836 Licensed 1740309889 LMFT 52444 Y
Angelo Pasa CATS OUTPATIENT 1836 Licensed 1689874125 RN 691250 Y
Beverly Thompson CATS OUTPATIENT 1836 Waivered 1528311230 ACSW 70671 Y
Carolyn Walters CATS OUTPATIENT 1836 Licensed 1891815155 LMFT 43069 Y
Eloisa Velasco CATS OUTPATIENT 1836 Licensed 1740797976 PT 40651 Y
Francisco Arreola CATS OUTPATIENT 1836 waivered 1417359027 AMF 87821 Y
Heidi McHenry CATS OUTPATIENT 1836 Licensed 1861763294 PT 35949 Y
Helen Sprague CATS OUTPATIENT 1836 Waivered 1710325642 AMFT 75120 Y
Jane Sanchez CATS OUTPATIENT 1836 Licensed 1346406824 LMFT 50808 Y
Jannelle Heard CATS OUTPATIENT 1836 Waivered 1467813568 AMFT 95836 Y
Kara Herrick CATS OUTPATIENT 1836 Licensed 1518191659 LMFT 43283 Y
Keith Amador CATS OUTPATIENT 1836 Licensed 1891127403 LMFT 102725 Y
Cynthia Morishige CATS OUTPATIENT 1836 Licensed 1649396045 LCSW 13592 Y
Remedios Wallace CATS OUTPATIENT 1836 Licensed 1639294341 PT 24227 Y
Luis Garcia CATS OUTPATIENT 1836 Licensed 1346599677 LMFT 10398 Y
Maria Ayala CATS OUTPATIENT 1836 Waivered 1174991129 APCCI 3382 Y
Marie Daguman CATS OUTPATIENT 1836 Waivered 1619483237 ACSW 79980 Y
Mary Montgomery CATS OUTPATIENT 1836 Licensed 1538281183 LCSW82129 Y
Megan Curtiss CATS OUTPATIENT 1836 Waivered 1265836027 AMFT 107915 Y
Priscilla Kavanagh CATS OUTPATIENT 1836 Waivered 1528429057 APCC2122 Y
Elizabeth DeGravio CATS OUTPATIENT 1836 Licensed 1497167530 PT 37500 Y
Ramil Doronio CATS OUTPATIENT 1836 Licensed 1871767376 RN 555151 Y
Ronee Martin CATS OUTPATIENT 1836 Waivered 1932644796 AMFT 84987 Y
Sasha Jackson CATS OUTPATIENT 1836 Waivered 1295181295 ACSW 79996 Y
Sherri Helsby CATS OUTPATIENT 1836 Licensed 1669893764 LCSW 29248 Y
Tiffany DeWitte CATS OUTPATIENT 1836 Licensed 1023143245 LCSW 29826 Y
Valerie-Ann Garcia CATS OUTPATIENT 1836 Licensed 1770606386 RN 704233 Y
Savoeun Phal CATS OUTPATIENT 1836 Waivered 1821513946 APCC 5278 Y
Joshua Merrill CATS OUTPATIENT 1836 Waivered 1114463957 AMFT 102798 Y
Gerado Manansala CATS OUTPATIENT 1836 Licensed 1215195813 A 102439 Y
Paul Mascovich CATS OUTPATIENT 1836 Licensed 1215921184 G 33950 Y
Jin Soofi CATS OUTPATIENT 1836 Licensed 1972592939 G 86240 Y
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Sheril Keys CATS OUTPATIENT 1836 Licensed 1942664875 PT 38333 Y
Thomas Firnberg CATS OUTPATIENT 1836 Licensed 1164597472 A 040218 Y
Mohammad Jahangiri CATS OUTPATIENT 1836 Licensed 1720266760 A 56400 Y
Fouad Saddik CATS OUTPATIENT 1836 Licensed 1437254117 A 44865 Y
Kellie Salazar CATS OUTPATIENT 1836 Licensed 1295273654 PT 40326 Y
Suryabamu Javeed CATS OUTPATIENT 1836 Licensed 1568567105 A 56307 Y
Robert Graff CATS OUTPATIENT 1836 Licensed 1366560112 G 70479 Y
Chestermagno De La Cruz CATS OUTPATIENT 1836 Licensed 1619476637 PT40672 Y
6 Community
Corrections Partnership Rico Molina AB10920 licensed 1255454203 LCSW25450 Y
Lawrence Shaddix AB10920 licensed 1508282286 IMF84560 Y
Randolph Herrington AB10920 licensed 1114141173 LMFT48970 Y
7 Crisis Community
Response Team (CCRT) Williams Wendy CCRT
MHC III
1265554638 LMFT 84045
Y
Ballesteros Patricia CCRT MHC 1790058352 LMFT 108455 Y
8 Crisis Intervention
Services Graff Robert CrisisMD
1366560112 G70479Y
Gill Paramijit Crisis MD 1073629218 A49224 Y
Firnberg Thomas Crisis MD 1164597472 A040218 Y
Singh Karamjit Crisis MD 1083930440 A132050 N
Singh Amanpreet Crisis MD 1235182916 A78414 N
Lee Catherine Crisis MHC III 1073729646 LMFT 44225 Y
Saleem Noshela Crisis MHC III 1255585584 LCSW 67154 Y
Williams Wendy Crisis MHC III 1265554638 LMFT 84045 Y
Galindo Teresa Crisis MHC III 1700119369 LCSW 69736 Y
Molina-Eliab Sonya Crisis MHC 1497878482 AMFT 99087 Y
Tran Michelle Crisis MHC 1366642068 LCSW 81278 Y
Figueroa Carlos Crisis MHC 1306193933 LMFT 102315 Y
Ballesteros Patricia Crisis MHC 1790058352 LMFT 108455 Y
Nobles Shannon Crisis MHC 1457699720 AMFT 101531 Y
Saelee Cindy Crisis MHC 1255511614 LCSW 82456 Y
Maney Stephen Crisis MHC 1083985998 ASW 78482 Y
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Lewman Brenda Crisis MHC 1821477035 LMFT106905 Y
Morales Leonardo Crisis MHC 1962822643 ASW 72730 Y
Grant Anika Crisis MHC 1649697137 AMFT 104116 Y
Sullivan Aisha Crisis MHC 1861772253 LCSW 75323 Y
Hodge Lewie Crisis MHC 1477044931 ASW 80338 N
Donato Imelda Crisis MHC 1194278085 APCC 2409 N
Redoblado Sheryl Crisis MHC 1871731513 LCSW 75136 Y
Walter Taffie Crisis CPT 1083735096 PT 32090 Y
DeJesus Carolyn Crisis CPT 1861650228 PT 34221 Y
McArthur Milagros Crisis PT 1477809929 PT 36471 Y
Olsen Chandra Crisis PT 1770914061 PT 37210 Y
Isham Loni Crisis PT 1891145033 PT 38233 Y
Bazua Melissa Crisis PT 1972944072 PT 36496 Y
Wright-Freeman Cody Crisis PT 1538584859 PT 37819 Y
Bareng Jeff Crisis PT 1043753478 PT 40284 Y
Gill Sandeep Crisis PT 1871852673 PT 34942 Y
Quitoriano Stephanie Crisis PT 1659798130 PT 37033 Y
Otero Luis Crisis PT 1487015582 PT 38229 Y
Price Jennifer Crisis PT 1932621893 PT 40662 Y
Kemp Sydney Crisis PT 1902383623 PT 34601 Y
9 Crisis Stabilization
Units (CSU) Graff Robert CSUMD
1366560112 G70479Y
Allanki Sailaja CSU MD 1306897723 C138838 Y
Singh Karamjit CSU MD 1083930440 A132050 N
Brown Brandi CSU RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth CSU RN 1255459061 RN 488617 Y
Seraypheap Arunny CSU RN 1013037274 RN 547944 Y
Limas Deborah CSU RN 1073631727 RN 526984 Y
Winck Angela CSU RN 1083002992 RN 701021 Y
Cabrera Gilbert CSU RN 1679693766 RN 565185 Y
Mendoza Michelle CSU RN 1477951812 RN 797022 Y
Blackman Demerica CSU RN 1932619517 RN 850647 Y
Laizer Gloria CSU RN 1255706479 RN 764452 Y
Odametey Ama CSU RN 1700366358 RN 835504 N
Hawkins Lynnetta CSU MHC III 1437436938 LMFT 93110 Y
Lambert Rekha CSU MHC 1164647525 LMFT 10386 Y
Nguyen Thao CSU MHC 1912214065 LMFT 88176 Y
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Navarro Grace CSU MHC 1083737753 ASW 72678 Y
Limas Stephanie CSU MHC 1053433748 LMFT 99397 Y
Little Christy CSU PT 1497978795 PT 28731 Y
Abundez Jesse CSU CPT 1841413036 PT 29162 Y
Montantes Michael CSU CPT 1780018390 PT 37071 Y
DeJesus Carolyn CSU CPT 1861650228 PT 34221 Y
Arriola Eulalie CSU CPT 1255573044 PT 34426 Y
Hardy Denise CSU PT 1912202813 PT 33714 Y
Harbin Toni CSU PT 1639475049 PT 28726 Y
Fortes Catherine CSU PT 1346681442 PT 36982 Y
Mocko James CSU PT 1558726224 PT 38249 Y
Menius Victoria CSU PT 1487074258 PT 37534 Y
Brown Kristaline CSU PT 1750723821 PT 32575 Y
Thorpe William CSU PT 1326599770 PT 40154 Y
Look Jasmin CSU PT 1194143198 PT 37492 Y
Mariano Joseph CSU PT 1609208172 PT 36968 Y
Marglin Lisa CSU PT 1558733576 PT 38247 Y
Clutario Dindo CSU PT 1164664512 PT 34295 Y
Ripoyla Jerral CSU PT 1821511700 PT 40644 Y
Varquez Sharon CSU PT 1366682387 PT 34435 Y
Holmes Sherronya CSU PT 1205214228 PT 37605 Y
Duncan Deanna CSU PT 1043674963 PT 38260 Y
Vang Mai CSU PT 1982103081 PT 40697 Y
Vong Tharith CSU PT 1134624802 PT 40678 N
Ridad Anthony CSU PT 1659887750 PT 40713 Y
Hill Brandon CSU PT 1053803890 PT 40412 Y
Singh Jasvir CSU PT 1477833911 PT 36007 Y
Kottke Marline CSU LVN 1891223111 LVN 198957 Y
10 Forensic Court Full
Service Partnership Edward Olpin BHSJDDSAS licensed 1477687077 LCSW24055 Y
Betsey McCall-Salerno BHSJDDSAS licensed 1740574672 LMFT42444 Y
Isabella Padilla Pereira Forensic74 licensed 1174871818 LMFT97934 Y
Alexander Anderson Forensic MCST74 licensed 1417183385 ASW70838 Y
Joseph Zummo Forensic74 licensed 1497927487 AMFT105417 Y
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
11 Gaining Older Adult
Life Skills (GOALS)
Full Service Partnership
(MHSA) Crystal Thao GOALS 7523 Waivered 1609183748 ACSW 35249 Y
Jessica Preston GOALS 7523 Waivered 1649727066 ACSW 79154 Y
Karla Romero GOALS 7523 Waivered 1083133276 AMFT 100573 Y
Tracy House GOALS 7523 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi GOALS 7523 Licensed 1093911224 LMFT 40177 Y
Sue Gruber GOALS 7523 Licensed 1811014780 LCSW 29008 Y
Christine Blue GOALS 7523 Licensed 1093786683 A 10733 Y
Katheine Hedrick GOALS 7523 Licensed 1043699333 RN 683243 Y
Cynthia Resendez GOALS 7523 Licensed 1780877845 A84098 Y
12 InSpire (MHSA) Debra Baker InSprire 7023 Waivered 1740610229 AMFT 95836 Y
Elizabeth DeGravio InSprire 7023 Licensed 1497167530 PT 37500 Y
13 La Familia Clinic Full
Service Partnership Nancy Nelson BHS La Familia Psychiatrist 1376635680 Physician and Surgeon C50283 Y
Jane Fernandez BHS La Familia Psychiatrist 1194799395 Physician and Surgeon A93060 Y
Pamela Smith BHS La Familia Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Aravind Pai BHS La Familia Psychiatrist (Locum) 1235182916 Physician and Surgeon A30319 N
Cynthia Resendez BHS La Familia Psychiatrist 1780877845 Physician and Surgeon A84098 Y
Donna Bickham BHS La Familia Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS La Familia Registered Nurse 1124143474 Registered Nurse 352081 Y
Kathleen Wilson-Parish BHS La Familia Program ManagerLMFT 1780807636 Licensed Marriage and Family Therapist LMFT50051 Y
Marium Walker BHS La Familia MH Clinician III LMFT 1316064975 Licensed Marriage and Family Therapist LMFT30367 Y
Alexander Largaespada BHS La Familia Clinician 1881902161 Marriage and Family Therapist Intern IMF93473 Y
Lynn Tarrant BHS La Familia Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
Adriana Cruz BHS La Familia Clinician II 1871612697 Licensed Clinical Social Worker LCSW81643 Y
Scarlette Aranda BHS La Familia Clinician I 1295929529 Associate Clinical Social Worker 83748 Y
Donnelle Tamayo BHS La Familia Staff Nurse IV 1073871216 Registered Nurse 551864 Y
Gloria Cruz BHS La Familia Staff Nurse III 1104375724 Registered Nurse 723203 Y
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
14 Mary Graham
Childrens Shelter Renessa Castaneda-Jensen Mary Graham Childrens Shelter 9008 Licensed 1376664862 81528 LMFT Y
15 MHSA TAY FSP Heidi McHenry TAY FSP Licensed 1861763294 PT 35949 Y
Jannelle Heard TAY FSP Waivered 1467813568 AMFT 95836 Y
Ronee Martin TAY FSP Waivered 1932644796 AMFT 84987 Y
Sasha Jackson TAY FSP Waivered 1295181295 ACSW 79996 Y
16 Older Adult Services
(OAS) Crystal Thao OAS 8236 Waivered 1609183748 ACSW 35249 Y
Jessica Preston OAS 8236 Waivered 1649727066 ACSW 79154 Y
Karla Romero OAS 8236 Waivered 1083133276 AMFT 100573 Y
Tracy House OAS 8236 Licensed 1720503550 PT 32050 Y
Michelle Garibaldi OAS 8236 Licensed 1093911224 LMFT 40177 Y
Sue Gruber OAS 8236 Licensed 1811014780 LCSW 29008 Y
Christine Blue OAS 8236 Licensed 1093786683 A 10733 Y
Katheine Hedrick OAS 8236 Licensed 1043699333 RN 683243 Y
Cynthia Resendez OAS 8236 Licensed 1780877845 A84098 Y
17 Peterson Hall Jennifer Domingo Peterson Hall 9009 Licensed 1104097286 50961 LMFT Y
Shabneet Hira Brar Peterson Hall 9009 Licensed 1851598452 A112447 Psychiatrist Y
Karina Jimenez Peterson Hall 9009 Waivered 1477891679 78261 AMFT Y
Helan Nguyen Peterson Hall 9009 Waivered 1801135876 85251 AMFT Y
Shiella Pablico Peterson Hall 9009 Licensed 1588036321 37620 Licensed Psychiatric Technician Y
Joann Ridad Peterson Hall 9009 Licensed 1922598135 40823 Licensed Psychiatric Technician Y
Abdollah Sabet Peterson Hall 9009 Licensed 1366468555 C53401 Psychiatrist Y
Carla Simien Peterson Hall 9009 Licensed 1629564000 40771 Licensed Psychiatric Technician Y
Fay Vieira Peterson Hall 9009 Licensed 1982815684 50276 LMFT Y
18 Psychiatric Health
Facility (PHF)Gill Paramijit
PHF MD
1073629218 A49224Y
Hart Robert PHF MD 1477660074 C38923 Y
Silver Hilary PHF MD 1720201221 C33442 Y
Brown Brandi PHF RN 1316060023 RN 713008 Y
Arroyo Maria Elizabeth PHF RN 1255459061 RN 488617 Y
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Seraypheap Arunny PHF RN 1013037274 RN 547944 Y
Limas Deborah PHF RN 1073631727 RN 526984 Y
Winck Angela PHF RN 1083002992 RN 701021 Y
Cabrera Gilbert PHF RN 1679693766 RN 565185 Y
Mendoza Michelle PHF RN 1477951812 RN 797022 Y
Blackman Demerica PHF RN 1932619517 RN 850647 Y
Laizer Gloria PHF RN 1255706479 RN 764452 Y
Odametey Ama PHF RN 1700366358 RN 835504 N
Camello Bena PHF MHC 1053581116 LCSW 65302 Y
Shah Mamoona PHF MHC 1407978471 Waivered Y
Mills Rachelle PHF MHC 1326169350 LMFT 81070 Y
Little Christy PHF PT 1497978795 PT 28731 Y
Bomar Dolfa PHF CPT 1881817567 PT 31571 Y
DeJesus Carolyn PHF CPT 1861650228 PT 34221 Y
Varquez Sharon PHF PT 1366682387 PT 34435 Y
Pot Sambo PHF PT 1104378827 PT 33626 Y
Bou Jennifer PHF PT 1033652466 PT40281 Y
Sesante Maria PHF PT 1851515720 PT 30936 Y
Ota Robert PHF PT 1578786554 PT 33792 Y
Pinano Paolo PHF PT 1245352616 PT 33726 Y
Ruiz Ronald PHF PT 1700907094 PT 27494 Y
Villasenor Kendra PHF PT 1447518204 PT 36449 Y
Deol Sukhvinder PHF PT 1508988593 PT 30288 Y
Bokelman Roy PHF PT 1114040003 PT 32628 Y
Seba Vicki PHF PT 1639291636 PT 31714 Y
Siador Jill PHF PT 1366884058 PT 36818 Y
Polk Rhonda PHF PT 1316160146 PT 20798 Y
Zorea Dylan PHF PT 1467573766 PT28206 Y
Chapin Larry PHF PT 1528200169 PT 26162 Y
19 San Joaquin County
MH Services Lodi Clinic Ruth Johnson Lodi Outpatient 6036 Licensed 1265535538 LCSW 15213 Y
Judith Dolyniuk Lodi Outpatient 6036 Licensed 1518182534 LMFT 97680 Y
Amy Massie Lodi Outpatient 6036 Waivered 1356798391 AMFT 100785 Y
Shayne Maniti Lodi Outpatient 6036 Licensed 1689854093 PT 33732 Y
Saba Rizvi Lodi Outpatient 6036 Licensed 1619190501 A 95786 Y
Avramov Valentin Lodi Outpatient 6036 Licensed 1053488767 109609 Psychiatrist Y
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Hill Patricia Lodi Outpatient 6036 Licensed 1902926231 23764 LCSW Y
Mann Bhupinderpreet Lodi Outpatient 6036 Waivered 1174603039 80464 AMFT Y
20 San Joaquin County
MH Services Tracy Clinic Ashley Smerdon Tracy Clinic 6136 Waivered 1265713929 MFT87560 Y
Jennifer Spruill Tracy Clinic 6136 Licensed 1518232321 LCSW 69544 Y
Simone Litsch Tracy Clinic 6136 Licensed 1598882599 A 89254 Y
Aravind Pai Tracy Clinic 6136 Licensed 1629076088 A30319 N
Gabriel Holguin Tracy Clinic 6136 Licensed 1255704094 PT38216 Y
21 SJC- MHS CYS Katie
A Services Sailaja Allanki CYS Katie A Services 9020 Licensed 1306897723 138838 Psychiatrist Y
Kristina Birch CYS Katie A Services 9020 Waivered 1366874844 1809 APCC Y
Maria Boklund CYS Katie A Services 9020 Licensed 1396157061 48496 LMFT Y
Linda Brett CYS Katie A Services 9020 Licensed 1295853299 523914 RN Y
Renessa Castaneda-Jensen CYS Katie A Services 9020 Licensed 1376664862 81528 LMFT Y
Maria Gamino CYS Katie A Services 9020 Waivered 1710386453 73292 ASW N
Shabneet Hira Brar CYS Katie A Services 9020 Licensed 1851598452 A112447 Psychiatrist Y
Catherine Navarrete CYS Katie A Services 9020 Waivered 1619456076 105076 Marriage amp Family Therapist Y
Leora Pollock CYS Katie A Services 9020 Licensed 1245663426 75192 LCSW Y
Kim Saing CYS Katie A Services 9020 Licensed 1982722666 51242 LMFT Y
Anastacia Stanley CYS Katie A Services 9020 Licensed 1528299724 87417 LMFT N
Patricia Young CYS Katie A Services 9020 Waivered 1780051375 94965 ASSOCIATE MARRIAGE amp FAMILY THERAPIST Y
22 Transcultural Clinic
(TCC) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
23 Southeast Asian
Recovery Services
(SEARS) Syed Kazmi BHS TCCSEARS Psychiatrist 1437310273 Physician and Surgeon A33815 Y
Pamela Smith BHS TCCSEARS Psychiatrist (Locum) 1902889694 Physician and Surgeon G84663 Y
Donna Bickham BHS TCCSEARS Deputy DirectorLCSW 1003099177 Licensed Clincial Social Worker LCSW27558 Y
Shirley Hollowell BHS TCCSEARS Registered Nurse 1124143474 Registered Nurse 352081 Y
Michelle Salter BHS TCCSEARS Program ManagerLMFT 1558483412 Licensed Clinical Social Worker LCSW11665 Y
Maly Xiong BHS TCCSEARS MH Clinician III LMFT 1932218849 Licensed Marriage amp Family Therapist LMFT86055 Y
Alexsandria Lose BHS TCCSEARS Clilnician I 1053557306 Associate Marriage amp Family Therapist AMFT98396 Y
Angela Egbuchulam BHS TCCSEARS Clinician II 1700231321 Associate Clinical Social Worker ASW61343 Y
Myrna Navarro BHS TCCSEARS Clinician II 1689796708 Licensed Clinical Social Worker LCSW75937 y
Quynh-Chi Nguyen BHS TCCSEARS Staff Nurse III 1417371014 Registered Nurse 845080 Y
Christopher Chow BHS TCCSEARS MH Psychiatric Technician 1124530100 Licensed psychiatric Technician PT38077 Y
Gloria Cruz BHS TCCSEARS Staff Nurse III 1104375724 Registered Nurse 723203 Y
Donnelle Tamayo BHS TCCSEARS Staff Nurse IV 1073871216 Registered Nurse 551864 Y
CONTRACT ORGANIZATIONAL PROVIDERS
24 Anka Lodi ( was
Mourfield House) Meloney West Anka Lodi AMFT 1649523283 Y
Eon Lawrence Losefa Anka Lodi LMFT 1982898276 104807 Y
Aaron Fett Anka Lodi Psychology Intern 1932352424 Y
25 ASPIRAnet Courtney Warfield-Gibbs ASPIRAnet Waivered 1285958520 ACSW 70918 Y
Melissa Wimer ASPIRAnet Licensed 1467946301 LMFT 81226 Y
Patricia A Jackson ASPIRAnet Waivered 1780848853 AMFT 73975 Y
Vijai Pandey ASPIRAnet Waivered 1710497938 AMFT 70416 Y
Amir Siddiqui ASPIRAnet Waivered 1336617844 APCC 5341 Y
26 Bright House Roberrt Lee Majors Bright House LMFT 1780692806 49236 Y
27 Casa Pacifica - OUT OF COUNTY PROVIDER
28 CBIS (University of the Pacific)- NON LICENSED STAFF ONLY
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
29 Chamberlains Children Center Inc -OUT OF COUNTY PROVIDER
30 Charis Youth Center- OUT OF COUNTY PROVIDER
31 Child Abuse
Prevention Council Karen Jacka Child Abuse Prevention Council LCSW 1790908788 16470 Y
Cassandra Lowe Child Abuse Prevention Council AMFT 1205278694 75983 Y
Stacey Tidwell Child Abuse Prevention Council ACSW 1790189413 72578 Y
Nazia Khan Child Abuse Prevention Council AMFT 1508227158 81499 Y
Lisa Aguilar Child Abuse Prevention Council ACSW 1417401035 73365 Y
Anabel Montejano Child Abuse Prevention Council ACSW 1740656636 78974 Y
Catherine Thiel Child Abuse Prevention Council LCSW 1134569791 82263 Y
Michelle Nelson Child Abuse Prevention Council AMFT 1891173357 94133 Y
Maria Cardoza Child Abuse Prevention Council AMFT 1467861252 87554 Y
Thear Chum Child Abuse Prevention Council ACSW 1134648231 83947 Y
Kaitlyn Reilly Child Abuse Prevention Council ACSW 1205381613 83651 Y
Laura Rodriguez Child Abuse Prevention Council ACSW 1316498892 78113 Y
Diana Strimling Child Abuse Prevention Council AMFT 1316221765 104452 Y
32 Community Re-Entry Program (CRP)- NON LICENSED STAFF ONLY
33 Crestwood Solano (PHF)- Out of County Provider
34 Crittenton Services For Children and Families -OUT OF COUNTY PROVIDER
35 Edgewood Center for Children and Families- OUT OF COUNTY PROVIDER
36 Fred Finch Youth Center- OUT OF COUNTY PROVIDER
37 Grant House Meloney West Grant House AMFT 1649523283 Y
JoAnn Marie Cornelius Grant House LPT 1205877727 35804 Y
Melinda Carchidi Grant House Psychology Intern 1609151653 Y
38 Latino Behavioral
Health and Recovery
Services Alexander Largaespada Latino Behavioral Health AMFT 181902161 AMFT 93473 Y
Maria De La Luz Torres Latino Behavioral Health ACSW 1003323361 ASW80844 N
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Lynn Tarrant Latino Behavioral Health Clinician 1609993021 Licensed Marriage and Family Therapist LMFT18630 N
39 Martin Gipson Socialization Center- NON LICENSED STAFF ONLY
40 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
41 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
42 Mountain Valley Child and Family Services Inc - OUT OF COUNTY PROVIDER
43 Mountain Valley Child and Family Services Inc- OUT OF COUNTY PROVIDER
44 Phoenix House of Los Angeles Inc- OUT OF COUNTY PROVIDER
45 Rebekah Childrens
Home Bhatti Moeen Rebekah Childrens Home licensed 1205023736 A 100193 Physician amp SurgeonMD DEA FB4071332 Y
Cervantes Priscilla Rebekah Childrens Home licensed 1679081582 693037 LVN N
Delgado Melissa Rebekah Childrens Home licensed 1881002186 105380 LMFT Y
Downey Ruth Rebekah Childrens Home licensed 1790161339 100524 LMFT Y
Machuca Lopez Cynthia Rebekah Childrens Home waivered 1386053817 74884 ACSW Y
Moeller Ryan Rebekah Childrens Home waivered 1316303803 91385 AMFT Y
Vaca-Preez Alejandra Rebekah Childrens Home waivered 1629418876 36752 ACSW Y
Vargas-Gladen Rosalva Rebekah Childrens Home licensed 1326114372 46940 LMFT Y
46 Sacramento Childrens Home- OUT OF COUNTY PROVIDER
47 San Gabriel Childrens Center Out Patient- OUT OF COUNTY PROVIDER
48 Star View Adolescent Center OP- OUT OF COUNTY PROVIDER
49 Summitview Child Treatment Center- OUT OF COUNTY PROVIDER
50 Telecare (aka Jeremy
House) Jessica Reiland Telecare- Jeremy House ASW (waived) Clinician 1003154634 70377 Y
Thuy Huynh Telecare- Jeremy House LPT Nurse 1033485495 36454 Y
Shannan Taylor Telecare- Jeremy House LMFT Regional Director 1528074770 LMFT46081 Y
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
51 Telecare Early
Intervention Recovery
Services (TEIRS) Melissa Planas ` LCSW 1679807994 LCSW66499 Y
Holli Hoffman TEIRS DNP 1144380940 2005000091 Y
Oshalique Bass TEIRS PCCI Waived 1477811677 5490 Y
Tran tran TEIRS LVN 1477084671 VN 275938 Y
Jennifer Miles TEIRS MD 1275541641 G83528 Y
Shannan Taylor TEIRS LMFT 1528074770 LMFT46081 Y
52 TLC Child and Family Services- OUT OF COUNTY PROVIDER
53 Valley Community
Counseling Services
(VCCS) (Manteca) 9040 Muhammad Kamran VCCS Manteca 9040 Licensed 1811051337 C53847 Psychiatrist Y
Patricia Goodman VCCS Manteca 9040 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Manteca 9040 Clinician 1578734687 AMFT 80527 Y
Alisha Sweyd VCCS Manteca 9040 Clinician 1689059941 AMFT 96911 Y
Teresa Viles-Reed VCCS Manteca 9040 Clinician 1386762623 PhD PSY14848 Y
54 Valley Community
Counseling Services
(VCCS) (School Based
Program- Stockton)
9042 Cynthia Aguilera VCCS Stockton 9042 Clinician 1003326182 AMFT 102123 Y
Melanie Almada VCCS Stockton 9042 Clinician 1912396532 AMFT 92167 Y
Arica Arucan VCCS Stockton 9042 Clinician 1215258280 LCSW 72691 Y
Megan Bassi VCCS Stockton 9042 Clinician 1669833885 AMFT 91956 Y
Manjit Belanger VCCS Stockton 9042 Clinician 1255780771 AMFT 100537 Y
Ana De Trinidad VCCS Stockton 9042 Clinician 1043501570 AMFT 95408 Y
Tiffany Drake VCCS Stockton 9042 Clinician 1417456617 AMFT 103265 Y
Sarah Gard VCCS Stockton 9042 Clinician 1477966265 LMFT 106055 Y
Patricia Goodman VCCS Stockton 9042 Clinician 1497979256 LMFT 51544 Y
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Carolyn Hider VCCS Stockton 9042 Clinician 1578734687 AMFT 80527 Y
Alicia Jackson VCCS Stockton 9042 Clinician 1912386525 AMFT 93526 Y
Naomi Jimenez VCCS Stockton 9042 Clinician 1669927828 AMFT 80527 Y
Leonard Lippert VCCS Stockton 9042 Clinician 1154691137 AMFT 101758 Y
Sandra McBride VCCS Stockton 9042 Clinician 1033467030 AMFT 75525 Y
Monika Muy VCCS Stockton 9042 Clinician 1982008603 ACSW 67390 Y
Desiree Nease VCCS Stockton 9042 Clinician 1447703491 ACSW 71196 Y
Katelyn Nelson VCCS Stockton 9042 Clinician 1669998290 ACSW 77372 Y
Elaine Pike VCCS Stockton 9042 Clinician 1508875055 LMFT 45258 Y
Cristal Rodriguez VCCS Stockton 9042 Clinician 1760938740 AMFT 93861 Y
Reshma Roy VCCS Stockton 9042 Clinician 1073061784 ACSW 66474 Y
Belem Ruiz VCCS Stockton 9042 Clinician 1508380411 AMFT 100924 Y
Jenna Santoyo VCCS Stockton 9042 Clinician 1457584567 LCSW 29827 Y
Riah Skrinnik VCCS Stockton 9042 Clinician 1295275592 APCC 3532 Y
Kristyn Towers VCCS Stockton 9042 Clinician 1942671052 AMFT 89172 Y
Alexsandra Trejo VCCS Stockton 9042 Clinician 1750837985 AMFT 92738 Y
Vichra You VCCS Stockton 9042 Clinician 1013437714 AMFT 99071 Y
55 Valley Community
Counseling Services
(VCCS) (Tracy) 9041 Muhammad Kamran VCCS Tracy 9041 Licensed 1811051337 C53847 Psychiatrist Y
Rosemary Cervantes VCCS Tracy 9041 Clinician 1407299738 AMFT 72397 Y
Laura Strickland VCCS Tracy 9041 Clinician 1538354543 2012633 Y
Lani Westervelt VCCS Tracy 9041 Clinician 1629191366 LMFT 38654 Y
56 Victor Community
Services and Support
Stockton (VCSS) 9063 Loiuse Cerna VCSS Stockton 9063 MFTI 1346794690 92730 - Marriage and Fmily Therapist Intern Y
Aziza Citi VCSS Stockton 9063 LMFT 1831510650 96329 - Licensed Marriage and Family Therapist Y
Melissa Colon VCSS Stockton 9063 MFTI 1871663351 77340 - Marriage and Family Therapist Intern Y
Itzia Cruz VCSS Stockton 9063 ACSW 1639533987 80056 - Associate Clinical Social Worker Y
Tracy Cutino VCSS Stockton 9063 LMFT 1740297902 47897 - Licensed Marriage and Family Therapist Y
Betia Dadkhah VCSS Stockton 9063 LMFT 1083709380 44160 - Licensed Marriage and Family Therapist Y
Mark Edelstein VCSS Stockton 9063 MD 1972516714 C41340 - Physician amp Surgeon Y
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Sharee Esparza VCSS Stockton 9063 MFTI 1982145504 102079 - Marriage and Family Therapist Intern Y
Tanner Hickman VCSS Stockton 9063 ACSW 1194272146 78099 - Associate Clinical Social Worker Y
Courtney Ivy VCSS Stockton 9063 MFTI 1679959217 71048 - Marriage and Family Therapist Intern Y
Giana Kooger VCSS Stockton 9063 LMFT 1720318132 86206 - Licensed Marriage and Family Therapist Y
Sheree Lozano VCSS Stockton 9063 MFTI 1538523501 88637 - Marriage and Family Therapist Intern Y
Christina Lopez VCSS Stockton 9063 MFTI 1265705727 102443 - Marriage and Family Therapist Intern Y
Koryn Marshall VCSS Stockton 9063 LMFT 1962881870 86263 - Licensed Marriage and Family Therapist Y
Adrianna Martinez VCSS Stockton 9063 MFTI 1851831242 107761 - Marriage and Family Therapist Intern Y
Laura Rodriguez VCSS Stockton 9063 ACSW 1316498892 78113 - Associate Clinical Social Worker Y
Jacquelyn Seefeldt VCSS Stockton 9063 MFTI 1124250204 74064 - Marriage and Family Therapist Intern Y
Heather Taylor VCSS Stockton 9063 LMFT 1265514251 44021 - Licensed Marriage and Family Therapist Y
Palei Triguero VCSS Stockton 9063 MFTI 1871994285 86335 - Marriage and Family Therapist Intern Y
Wendy True VCSS Stockton 9063 LMFT 1750476438 44262 - Licensed Marriage and Family Therapist Y
Jennifer Tutt VCSS Stockton 9063 LCSW 1316134091 27530 - Licensed Clinical Social Worker Y
Sarah Voss VCSS Stockton 9063 LMFT 1275602914 51406 - Licensed Marriage and Family Therapist Y
Michelle Zuckerman VCSS Stockton 9063 LMFT 1891948691 84298 - Licensed Marriage and Family Therapist Y
57 Victor Treatment Center - Santa Rosa- OUT OF COUNTY PROVIDER
58 Victor Youth Services (North Valley Schools)- OUT OF COUNTY PROVIDER
59 Womens Center- Family and Youth Services httpswwwwomenscenteryfsorgindexphpget-helptherapy-services
CONTRACT PSYCHIATRIC HOSPITALS
60 BHC Heritage Oaks Hospital - Out of County Hospital
61 BHC Sierra Vista Hospital - Out of County Hospital
62 St Helena Hospital Center for Behavioral Health - Out of County Hospital
63 John Muir Behavioral Health Center - Out of County Hospital
64 Sutter Center for Psychiatry - Out of County Hospital
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
65 Fremont Hospital - Alka Aneja Fremont Hospital ChildAdolescent MD 1619031317 A112029BA9881017 Y
Harmohinder Athwal Fremont Hospital ChildAdolescent MD 1740298256 A81841BA8179473 Y
Kamaljeet Boora Fremont Hospital Psychiatry MD 1356587711 102846FB0978823 N
Vikas Duvvuri Fremont Hospital EDO MD 1255470480 A99706FD0242064 Y
Trevor Fooks Fremont Hospital Psychiatry MD 1730267535 G63964BF1543695 Y
Ravinder Kahlon Fremont Hospital NeuroPsych MD 1386741320 A50823BK2018934 N
Vasdeep Kahlon Fremont Hospital Psychiatry MD 1497852446 A51243BK2742535 N
Padmavathi Kudaravalli Fremont Hospital Internal Medicine MD 1144221953 A67964BK6574974 Y
Pradeep Kumar Fremont Hospital Psychiatry MD 1023188935 A52032BK4202177 N
Deepak Kumar Fremont Hospital Psychiatry MD 1306257910 A130068FK4574299 Y
Sudha Manjunath Fremont Hospital ChildAdolescent MD 1801826797 A87131BM8982818 Y
Syed Munir Fremont Hospital ChildAdolescent MD 1790718815 C55029BM3999553 Y
Nanda Nayak Fremont Hospital Psychiatry MD 1477656262 A43182BN0687597 N
Falguni Patel Fremont Hospital ChildAdolescent MD 1548414337 A105594FP1152949 Y
Surender Punia Fremont Hospital Psychiatry MD 1376589663 A77004BP6477497 Y
Divya Reddy Fremont Hospital Psychiatry MD 1518120211 A103547FR1100306 Y
Devindar Singh Fremont Hospital Internal Medicine MD 1447294624 A48148BS2303422 N
Sunpreet Singh Fremont Hospital Psychiatry MD 1326464462 A132932FS5027087 Y
Bhupinder Waraich Fremont Hospital Psychiatry MD 1689869547 A53968BW4473346 Y
Jaap Kaur Waraich Fremont Hospital Psychiatry MD 1316132285 G67904BW2368391 Y
Nicholas Phillips Fremont Hospital Family Medicine MD 1255727293 A153125FP7288841 N
Harleen Dyal Fremont Hospital Family Medicine MD 1225424327 A153255FD7288839 N
SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY
66 Central Intake Unit-Referrals to Licensed Staff
67 Chemical
Dependency Counseling
Center ( CDCC) Tyler Moran Chemical Dependency Counseling Center 390002DN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Chemical Dependency Counseling Center 390002DN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Chemical Dependency Counseling Center 390002DN Psychiatrist 1710094057 A72805 Y
68 Alcohol amp Drug Alternative Program (ADAP)-Referrals to Licensed Staff
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
69 Family Ties Tyler Moran Family Ties 390002EN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Family Ties 390002EN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Family Ties 390002EN Psychiatrist 1710094057 A72805 Y
70 Recovery House Tyler Moran Recovery House 390002AN AMFT Intern 1114346848 AMFT100257 Y
Robert Raymond Hart Recovery House 390002AN Psychiatrist 1477660074 C38923 Y
Khurram Khan Durrani Recovery House 390002AN Psychiatrist 1710094057 A72805 Y
71 Adolescent Co- Occurring Treatment Program (ACT) Childrens Behavioral Health Services- Referrals to Licensed Staff
72 Prevention Services- Referrals to Licensed Staff
NARCOTIC TREATMENT PROGRAMSMEDICATION ASSISTED TREATMENT
73 Aegis Treatment
Center Dr Randall Paul Aegis Treatment Center Medical License 1912061045 A26361 Y
Linda Beccerra Aegis Treatment Center Vocation Nurse VN 183039 Y
Dora Berry Aegis Treatment Center Vocation Nurse VN 689493 Y
Jeannette Carter-Camp Aegis Treatment Center Vocation Nurse 1740480342 NP 7506 Y
Francisca Marquez Aegis Treatment Center Vocation Nurse VN 287402 Y
74 5th Street Medical
Clinic Stockton Dr Michael Fox 5th Street Medical Clinic Medical License 1212069758 G53561 Y
Melissa Whitworth 5th Street Medical Clinic Vocation Nurse RN 541037 Y
Divina Palafox 5th Street Medical Clinic Vocation Nurse 1912061995 VN 17300 Y
Divna Lu 5th Street Medical Clinic Vocation Nurse VN 183039 Y
Jeannette Carter-Camp 5th Street Medical Clinic Vocation Nurse 1740480342 NP 7506 Y
75 Aegis Treatment
CenterHealthy
Connections (California
St) Stockton Dr Michael Fox Aegis Treatment CenterHealthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Melissa Whitworth Aegis Treatment CenterHealthy Connections Vocation Nurse RN 541037 Y
Dr Brian Talleur Aegis Treatment CenterHealthy Connections Medical License 1659791101 A154190 Y
Alvin Goat Aegis Treatment CenterHealthy Connections Vocation Nurse VN 20473 Y
Crystal August Aegis Treatment CenterHealthy Connections Vocation Nurse VN 695962 Y
Rosenah Durago Aegis Treatment CenterHealthy Connections Vocation Nurse 1841629185 VN 235553 Y
Maria Garsuta Aegis Treatment CenterHealthy Connections Vocation Nurse VN 235825 Y
76 Healthy Connections
Lodi Clinic Melissa Whitworth Healthy Connections Lodi Clinic Vocation Nurse RN 541037 Y
Dr Brian Talleur Healthy Connections Lodi Clinic Medical License 1659791101 A154190 Y
Angeles Alfaro Healthy Connections Lodi Clinic Vocation Nurse 1649669979 VN 689129 Y
John Campos Healthy Connections Lodi Clinic Vocation Nurse 1407192297 VN 260740 Y
Prabhjot Kaur Healthy Connections Lodi Clinic Vocation Nurse VN 698775 Y
Meenal Prasad Healthy Connections Lodi Clinic Vocation Nurse 1114407368 VN 287331 Y
77 Manteca Healthy
Connections Dr Michael Fox Manteca Healthy Connections Medical License 1212069758 G53561 Y
Melissa Whitworth Manteca Healthy Connections Vocation Nurse RN 541037 Y
Dr Randall Paul Manteca Healthy Connections Medical License 1912061045 A26361 Y
Mary Jane Davis Manteca Healthy Connections Vocation Nurse 1861822744 VN 72342 Y
Christine Falcon Manteca Healthy Connections Vocation Nurse VN 175628 Y
Dourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 Y
Rebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y
78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton
LANGUAGE ASSISTANCE
English
Services may be delivered by an individual provider or a team of providers who is working under the direction of a licensed practitioner operating within their scope of practice Only licensed waivered or registered mental
health providers and licensed substance use disorder services providers are listed on the Plans provider directory
ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
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ATTENTION If you speak another language language assistance services free of charge are available to you Call 1-888-468-9370 (TTY 1-866-735-2922 )ATTENTION Auxiliary aids and services including but not limited to large print documents and alternative formats are available to you free of charge upon request Call 1-888-468-9370 (TTY 1-866-735-2922 ) Espantildeol (Spanish)
ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-888-468-9370 (TTY 1-866-735-2922 )
Tiếng Việt (Vietnamese)
CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-888-468-9370 (TTY 1-866-735-2922 )
Tagalog (Tagalog Filipino)
PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-888-468-9370 (TTY 1-866-735-2922 )한국어 (Korean)주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-888-468-9370 (TTY 1-866-735-2922 ) 번으로 전화해 주십시오繁體中文繁體中文繁體中文繁體中文(Chinese)注意如果您使用繁體中文您可以免費獲得語言援助服務請致電1-888-468-9370 (TTY 1-866-735-2922 )ՀայերենՀայերենՀայերենՀայերեն (Armenian)
ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ Զանգահարեք 1-888-468-9370 (TTY 1-866-735-2922 )
Русский (Russian)
ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-888-468-9370 (TTY 1-866-735-2922 )
(Farsi) فارسیتوجه اگر به زبان فارسی گفتگو می کنيد تسهيالت زبانی بصورت رايگان برای شما
日本語日本語日本語日本語 (Japanese)注意事項日本語を話される場合無料の言語支援をご利用いただけます1-888-468-9370فراهم می باشد با 468-888-1 (TTY 1-866-735-2922 ) までお電話にてご連絡ください
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-
Hmoob (Hmong)
LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj kev pab dawb rau koj Hu rau 1-888-468-9370 (TTY 1-866-735-2922 )
ਪਜਾਬੀ (Punjabi)
ਿਧਆਨ ਿਦਓ ਜ ਤਸੀ ਪਜਾਬੀ ਬਲਦ ਹ ਤਾ ਭਾਸ਼ਾ ਿਵਚ ਸਹਾਇਤਾ ਸਵਾ ਤਹਾਡ ਲਈ ਮਫਤ ਉਪਲਬਧ ਹ 1-888-468-9370 (TTY 1-866-735-2922) ਤ ਕਾਲ ਕਰ
(Arabic) العربية
ملحوظة إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان
हिदी (Hindi)
द यदि आप हिदी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए उपलबध ह [1-888-468-9370 (TTY 1-866-735-2922) पर कॉल कर
ภาษาไทย (Thai)
เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร โทร 1-888-468-9370 (TTY 1-866-735-2922) धयान
ែខរ (Cambodian)
បយត ររ េស នអកនយ ែខ រសជនយមននក េយមនគត នគចនស ររ អេ នក ច ទ សព+1-888-468-9370 (TTY 1-866-735-2922)
ພາສາລາວ (Lao)
ໂປດຊາບ ຖາວາ ທານເວາພາສາ ລາວ ການບລການຊວຍເຫອດານພາສາໂດຍບເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ 1-888-468-9370 (TTY 1-866-735-2922)
- 12-Font English Medi-Cal Provider Directory 3-2019 English
- Medi-Cal Directory Provider Staff Listing 12 font English 03-2019
-