Basic Information
| Provider Information | |||||||||
| NPI: | 1467950345 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PARENTS BY CHOICE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 306 E MAIN ST STE 300-312 | ||||||||
| Address2: | |||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952022908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2094784554 | ||||||||
| FaxNumber: | 2094781991 | ||||||||
| Practice Location | |||||||||
| Address1: | 306 E MAIN ST STE 300-312 | ||||||||
| Address2: | |||||||||
| City: | STOCKTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 952022908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2094784554 | ||||||||
| FaxNumber: | 2094781991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2018 | ||||||||
| LastUpdateDate: | 11/05/2020 | ||||||||
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| AuthorizedOfficialLastName: | YADON | ||||||||
| AuthorizedOfficialFirstName: | TONY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2092752487 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 11/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.