San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... ·...

93
San Joaquin County Behavioral Health Services County and Contract Medi-Cal Providers SJCBHS Medi-Cal Provider Directory_Rev.12/2018 33/201832/2018 Page 1 of 66 *See Provider Staff Listing **Non-English Languages, as well as American Sign Language are available upon request. Providers/ Provider Numbers Address Telephone # Website Addresses Hours of Operation Popu- lations Served Non- English Lang- uages (in addition to free Inter- preter Services) Including ASL** Provider Characteristics / Cultural Competency Medi-Cal Certified Service Categories Accept- ing New Clients Com- pleted Cultural Compe- tency Training Accommo- dations for people with Dis- abilities Yes/No Yes/No Yes/No COUNTY OWNED & OPERATED PROGRAMS: (24 hours a day, 7 days a week toll-free telephone number: 1-888-468-9370) 1*.Black Awareness Community Outreach Program/Multicultur al Services (BACOP/MC) - Full Service Partnership (MHSA) #9090 1149 N. El Dorado Street Stockton, CA 95202 (209) 468-2337 https://www.sjg ov.org/mhs 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, Muslim/Middle Eastern, and Gay/Lesbian/Bi- sexual/Transgender 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

Transcript of San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... ·...

Page 1: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 1 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

COUNTY OWNED amp OPERATED PROGRAMS (24 hours a day 7 days a week toll-free telephone number 1-888-468-9370)

1Black

Awareness

Community

Outreach

ProgramMulticultur

al Services

(BACOPMC) - Full

Service Partnership

(MHSA)

9090

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2337

httpswwwsjg

ovorgmhs

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

GayLesbianBi-

sexualTransgender

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 2 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

2Children and

Youth Services

Stockton Clinic

(CYS)

3915

1414 N California

Street

Stockton CA

95202

(209) 468-2385

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Children

and

Youth

Spanish

Russian

Ukran-

ian

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 3 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

3Children and

Youth Services -

Foster Youth Full

Service Partnership

(MHSA)

9096

1414 N California

Street

Stockton CA

95202

(209) 468-2385

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 4 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

4Children and

Youth Services -

Juvenile Justice Full

Service Partnership

(MHSA)

9095

1414 N California

Street

Stockton CA

95202

(209) 468-2385

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Children

and

Youth

Cambo-

dian

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 5 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

5Community

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Canton-

ese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 6 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

6Community

Corrections

Partnership

9039AP

1212 N California

Street

Stockton CA

95202

(209) 468-9373

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 7 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

7Crisis

Community

Response Team

(CCRT)

9088

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 8 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

8Crisis

Intervention

Services

9011

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

9Crisis

Stabilization

Units (CSU)

9032

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

24 hours

Adult

Adol-

escents

Older

Adult

Spanish

Cambo-

dian

Vietna-

mese

23-Hour psychiatric

assessment and

stabilization unit

Resources and

Referrals are

provided during

admission

Crisis Stabilization UC

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 9 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

10Forensic Court

Full Service

Partnership

(MHSA)

9091

1212 N California

Street Stockton CA

95202

(209) 468-8786

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 10 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

11Gaining Older

Adult Life Skills

(GOALS) Full

Service Partnership

(MHSA)

9093

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 2: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 2 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

2Children and

Youth Services

Stockton Clinic

(CYS)

3915

1414 N California

Street

Stockton CA

95202

(209) 468-2385

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Children

and

Youth

Spanish

Russian

Ukran-

ian

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 3 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

3Children and

Youth Services -

Foster Youth Full

Service Partnership

(MHSA)

9096

1414 N California

Street

Stockton CA

95202

(209) 468-2385

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 4 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

4Children and

Youth Services -

Juvenile Justice Full

Service Partnership

(MHSA)

9095

1414 N California

Street

Stockton CA

95202

(209) 468-2385

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Children

and

Youth

Cambo-

dian

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 5 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

5Community

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Canton-

ese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 6 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

6Community

Corrections

Partnership

9039AP

1212 N California

Street

Stockton CA

95202

(209) 468-9373

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 7 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

7Crisis

Community

Response Team

(CCRT)

9088

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 8 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

8Crisis

Intervention

Services

9011

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

9Crisis

Stabilization

Units (CSU)

9032

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

24 hours

Adult

Adol-

escents

Older

Adult

Spanish

Cambo-

dian

Vietna-

mese

23-Hour psychiatric

assessment and

stabilization unit

Resources and

Referrals are

provided during

admission

Crisis Stabilization UC

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 9 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

10Forensic Court

Full Service

Partnership

(MHSA)

9091

1212 N California

Street Stockton CA

95202

(209) 468-8786

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 10 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

11Gaining Older

Adult Life Skills

(GOALS) Full

Service Partnership

(MHSA)

9093

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 3: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 3 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

3Children and

Youth Services -

Foster Youth Full

Service Partnership

(MHSA)

9096

1414 N California

Street

Stockton CA

95202

(209) 468-2385

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 4 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

4Children and

Youth Services -

Juvenile Justice Full

Service Partnership

(MHSA)

9095

1414 N California

Street

Stockton CA

95202

(209) 468-2385

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Children

and

Youth

Cambo-

dian

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 5 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

5Community

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Canton-

ese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 6 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

6Community

Corrections

Partnership

9039AP

1212 N California

Street

Stockton CA

95202

(209) 468-9373

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 7 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

7Crisis

Community

Response Team

(CCRT)

9088

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 8 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

8Crisis

Intervention

Services

9011

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

9Crisis

Stabilization

Units (CSU)

9032

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

24 hours

Adult

Adol-

escents

Older

Adult

Spanish

Cambo-

dian

Vietna-

mese

23-Hour psychiatric

assessment and

stabilization unit

Resources and

Referrals are

provided during

admission

Crisis Stabilization UC

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 9 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

10Forensic Court

Full Service

Partnership

(MHSA)

9091

1212 N California

Street Stockton CA

95202

(209) 468-8786

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 10 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

11Gaining Older

Adult Life Skills

(GOALS) Full

Service Partnership

(MHSA)

9093

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 4: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 4 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

4Children and

Youth Services -

Juvenile Justice Full

Service Partnership

(MHSA)

9095

1414 N California

Street

Stockton CA

95202

(209) 468-2385

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Children

and

Youth

Cambo-

dian

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 5 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

5Community

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Canton-

ese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 6 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

6Community

Corrections

Partnership

9039AP

1212 N California

Street

Stockton CA

95202

(209) 468-9373

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 7 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

7Crisis

Community

Response Team

(CCRT)

9088

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 8 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

8Crisis

Intervention

Services

9011

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

9Crisis

Stabilization

Units (CSU)

9032

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

24 hours

Adult

Adol-

escents

Older

Adult

Spanish

Cambo-

dian

Vietna-

mese

23-Hour psychiatric

assessment and

stabilization unit

Resources and

Referrals are

provided during

admission

Crisis Stabilization UC

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 9 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

10Forensic Court

Full Service

Partnership

(MHSA)

9091

1212 N California

Street Stockton CA

95202

(209) 468-8786

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 10 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

11Gaining Older

Adult Life Skills

(GOALS) Full

Service Partnership

(MHSA)

9093

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 5: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 5 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

5Community

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Canton-

ese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 6 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

6Community

Corrections

Partnership

9039AP

1212 N California

Street

Stockton CA

95202

(209) 468-9373

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 7 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

7Crisis

Community

Response Team

(CCRT)

9088

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 8 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

8Crisis

Intervention

Services

9011

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

9Crisis

Stabilization

Units (CSU)

9032

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

24 hours

Adult

Adol-

escents

Older

Adult

Spanish

Cambo-

dian

Vietna-

mese

23-Hour psychiatric

assessment and

stabilization unit

Resources and

Referrals are

provided during

admission

Crisis Stabilization UC

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 9 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

10Forensic Court

Full Service

Partnership

(MHSA)

9091

1212 N California

Street Stockton CA

95202

(209) 468-8786

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 10 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

11Gaining Older

Adult Life Skills

(GOALS) Full

Service Partnership

(MHSA)

9093

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 6: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 6 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

6Community

Corrections

Partnership

9039AP

1212 N California

Street

Stockton CA

95202

(209) 468-9373

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 7 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

7Crisis

Community

Response Team

(CCRT)

9088

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 8 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

8Crisis

Intervention

Services

9011

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

9Crisis

Stabilization

Units (CSU)

9032

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

24 hours

Adult

Adol-

escents

Older

Adult

Spanish

Cambo-

dian

Vietna-

mese

23-Hour psychiatric

assessment and

stabilization unit

Resources and

Referrals are

provided during

admission

Crisis Stabilization UC

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 9 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

10Forensic Court

Full Service

Partnership

(MHSA)

9091

1212 N California

Street Stockton CA

95202

(209) 468-8786

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 10 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

11Gaining Older

Adult Life Skills

(GOALS) Full

Service Partnership

(MHSA)

9093

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 7: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 7 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

7Crisis

Community

Response Team

(CCRT)

9088

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 8 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

8Crisis

Intervention

Services

9011

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

9Crisis

Stabilization

Units (CSU)

9032

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

24 hours

Adult

Adol-

escents

Older

Adult

Spanish

Cambo-

dian

Vietna-

mese

23-Hour psychiatric

assessment and

stabilization unit

Resources and

Referrals are

provided during

admission

Crisis Stabilization UC

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 9 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

10Forensic Court

Full Service

Partnership

(MHSA)

9091

1212 N California

Street Stockton CA

95202

(209) 468-8786

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 10 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

11Gaining Older

Adult Life Skills

(GOALS) Full

Service Partnership

(MHSA)

9093

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 8: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 8 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

8Crisis

Intervention

Services

9011

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

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

9Crisis

Stabilization

Units (CSU)

9032

1212 N California

Street

Stockton CA

95202

(209) 468-8686

httpswwwsjg

ovorgmhs

24 hours

Adult

Adol-

escents

Older

Adult

Spanish

Cambo-

dian

Vietna-

mese

23-Hour psychiatric

assessment and

stabilization unit

Resources and

Referrals are

provided during

admission

Crisis Stabilization UC

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 9 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

10Forensic Court

Full Service

Partnership

(MHSA)

9091

1212 N California

Street Stockton CA

95202

(209) 468-8786

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 10 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

11Gaining Older

Adult Life Skills

(GOALS) Full

Service Partnership

(MHSA)

9093

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 9: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 9 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

10Forensic Court

Full Service

Partnership

(MHSA)

9091

1212 N California

Street Stockton CA

95202

(209) 468-8786

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 10 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

11Gaining Older

Adult Life Skills

(GOALS) Full

Service Partnership

(MHSA)

9093

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 10: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 10 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

11Gaining Older

Adult Life Skills

(GOALS) Full

Service Partnership

(MHSA)

9093

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 11: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 11 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

12InSPIRE

(MHSA)

39AN

1212 N California

Street

Stockton CA

95202

(209) 468-8880

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 12: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 12 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

13La Familia

Clinic Full

Service

Partnership

(MHSA)

9092

1149 N El Dorado

Street

Stockton CA

95202

(209) 468-2335

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

Latino

out-

reach

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 13: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 13 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

14Mary Graham

Childrens Shelter

9008

6861 Mary Graham

Lane

French Camp CA

95231

(209) 468-6966

httpwww

marygrahamfou

ndationorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
Page 14: San Joaq uin Cou nty Behavio ral Health S erv ices County and … English Medi-Cal Provider... · 2018. 12. 13. · San Joaq uin Cou nty Behavio ral Health S erv ices County and Contract

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 14 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services)

Include-

ing ASL

YesNo YesNo YesNo

15MHSA TAY

FSP

39B1

1212 N California

Street Stockton

CA 95202

(209) 468-8862

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 15 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

16Older Adult

Services (OAS)

3980

1212 N California

Street Stockton CA

95202

(209) 468-3760

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Older

Adult

Spanish

Cambo-

dian Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 16 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

Services

Includin

g ASL

YesNo YesNo YesNo

17 Peterson

Hall

9009

535 W Matthews

Rd French Camp

CA 95231

(209) 468-4240

hiipswwwsjg

ovorgmhs

M-F 8 am- 8

pm SatSun 10-

7 pm

Children

and

Youth

Cambo-

dian

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

18Psychiatric

Health

Facility (PHF)

3976

1212 N California

Street Stockton

CA 95202

(209) 468-8686

httpswwwsjg

ovorgmhs 24

hours

Adult Spanish

24-hour inpatient

hospitalization

services

Yes Yes Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 17 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

19San 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

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 18 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

20San Joaquin

County MH

Services Tracy

Clinic

9048

220 W Eleventh

Street

Tracy CA 95376

(209) 831-5941

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 19 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

21SJC-MHS

CYS Katie A

Services

9020

333 E Washington

Street

Stockton CA

95202

(209) 468-1547

httpswwwsjg

ovorgmhs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 20 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition to

free Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

22Transcultural

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 21 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

23Southeast

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

httpswwwsjg

ovorgmhs

M-F 8 am- 5

pm

Adult

Focus on

out-

reach

and

access

for the

South-

east

Asian

popu-

lation

Cambo-

dian

Laotian

Hmong

Viet-

namese

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

CONTRACT ORGANIZATIONAL PROVIDERS

24Anka Lodi (was

Mourfield House)

9075

458 Almond Drive

Lodi CA 95240

(209) 982-4697

wwwankabhior

g M-F 8am-5pm

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 22 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

25ASPIRAnet

39AR

6 S El Dorado

Street Suite 510

Stockton CA

95202

(209) 478-9862

wwwaspiranet

Org

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

26Bright House

9047

8210 Bright Road

French Camp CA

95231

(209) 982-1235

wwwankabhior

g 24 hours

Adult

Adult Transitional

Residential

Treatment Program

Medication Support

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 23 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

27Casa Pacifica

39AB

1722 S Lewis Road

Camarrillo CA

93012

(805) 981-1422

wwwcaspacific

aorg

M-F 8 am- 6 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

28CBIS

(University of the

Pacific)

39A1

405 E Pine Street

Stockton CA

95204

(209) 476-1959

wwwcommunit

yre-

entryprogramco

m M-F 8am-430

pm

Adult

Spanish

Behavioral

Intervention Services

Mental Health Services

Intensive Home Based

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 24 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

29Chamberlains

Children Center

Inc

39B4

1850 San Benito

Street

Hollister CA

95023

(831) 636-2121

wwwchamberla

inccorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 25 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

30Charis Youth

Center

9057

714 W Main Street

Grass Valley CA

95945

(530) 477-9800

wwwcharisyout

hcenterorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 26 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

31Child Abuse

Prevention Council

39A8

540 N California

Street

Stockton CA

95202

(209) 644-5311

wwwnochildab

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 27 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

32Community

Re- Entry

Program (CRP)

9044

405 E Pine Street

Stockton CA

95204

(209) 946-2132

wwwcommunit

yre-

entryprogramco

m

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

33Crestwood

Solano

(PHF)

39A8

2201 Tuolumne

Street Suite B

Vallejo CA 94589

(707) 558-1777

wwwcrestwood

behavioralhealth

com

24

hours

Adult

24-hour

inpatient

hospitalization

services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 28 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

34Crittenton

Services For

Children And

Families

39B3

100 E Valley View

Drive Fullerton CA

92832

(714) 680-8268

wwwcrittentons

ocalorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 29 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

35Edgewood

Center for

Children and

Families

39AV

1801 Vincente

Street San

Francisco CA

94116

(415) 681-3211

wwwedgewood

org

24

Hrs

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 30 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

36Fred Finch

Youth

Center

39AY

3800 Coolidge

AvenueOakland

CA 94602

(510) 482-2244

wwwfredfinch

Org

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

37Grant House

9064

1117 S Grant

Street Stockton

CA 95206

(209) 461-6500

wwwankabhior

g 24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 31 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

38Latino

Behavioral Health

and Recovery

Services

9067

445 N San Joaquin

Street

Stockton CA

95202

(209) 444-8910

wwwelconcilio

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 32 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

39Martin Gipson

Socialization Center

9043

405 E Pine Street

Stockton CA

95204

(209) 464-5519

wwwcommunit

yre-

entryprogramco

m

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 33 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

40Mountain

Valley Child and

Family Services

Inc

9039

24077 Highway 49

Nevada City CA

95959

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 34 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

41Mountain

Valley Child and

Family Services

Inc

39A4

7818 Bar Du Lane

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 35 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

42Mountain

Valley Child and

Family Services

Inc

39A3

6171 Bradshaw Rd

Sacramento CA

95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 36 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

43Mountain

Valley Child and

Family Services

Inc

39A2

9200 Sweet Acacia

Way Sacramento

CA 95829

(530) 265-9057

wwwmountainv

alleyfamilyorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 37 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

44Phoenix House

of

Los Angeles Inc

39B6

1600 Eldrige

Avenue Lake View

Terrace CA 91342

(818) 686-3000

wwwphoenixho

useorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 38 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

45Rebekah

Childrenrsquos

Home

39AU

290 IOOF Avenue

Gilroy CA 95020

(408) 846-2100

wwwrcskidsor

g

M-F 8 am- 530

pm

Children

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 39 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

46Sacramento

Childrens Home

9076

2750 Sutterville

Road Sacramento

CA 95820

(916) 452-3981

wwwkidshome

Org

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 40 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

47San Gabriel

Childrens Center

Out Patient

39B7

4740 N Grand

Avenue Covina CA

91724

(626) 859-2089

wwwsangabriel

childcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 41 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

48Star View

Adolescent Center

OP

39BB

4025 West 226th

Street

Torrance CA

90505

(310)373-4556

wwwstarsincco

m 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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 42 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

49Summitview

Child Treatment

Center

9061

670 Placerville Dr

2 Placerville CA

95667

(530) 644-2412

wwwsummitvie

wtreatmentorg

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

Support Crisis

Intervention

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 43 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

50Telecare (aka

Jeremy House)

39AX

5634 Jeremy Way

Stockton CA

95212

(209) 888-4969

wwwtelecareco

rpcom

24 hours

Adult

Crisis Residential

Treatment Program

Yes

Yes

Yes

51Telecare Early

Intervention

Recovery Services

(TEIRS)

39B2

4545 Georgetown

Place Suite A3

Stockton CA

95207

(209) 715-3754

wwwtelecareco

rpcom

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 44 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

52TLC Child and

Family Services

39A9

1800 Gravenstein

Hwy North Suite A

Sebastopol CA

95472

(707) 823-7300

httpwwwtlc4

kidsorg

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 45 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

53Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 46 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

54Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 47 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

55Valley

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 48 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

56Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 49 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

57Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 50 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

58Victor

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 51 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

59Womens

Center- Family

and Youth

Services

39B6

729 N California

Street Stockton

CA 95202

(209) 929-6700

wwwwomensce

nteryfsorg

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

CONTRACT PSYCHIATRIC HOSPITALS

60BHC Heritage

Oaks

Hospital

4250 Auburn

Boulevard

(916) 489-3336

wwwheritageoa

kshospitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 52 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

61BHC Sierra

Vista

Hospital

8001 Bruceville

Road

(916) 423-2000

wwwsierravista

hospitalcom

24 hours

All ages

Yes

Yes

Yes

62St Helena

Hospital Center for

Behavioral Health

525 Oregon Street

(707) 648-2200

wwwadventisth

ealthorg

24 hours

All ages

Yes

Yes

Yes

63John Muir

Behavioral Health

Center

2740 Grant Street

(925) 680-6500

wwwjohnmuirh

ealthcom

24 hours

All ages

Yes

Yes

Yes

64Sutter Center for

Psychiatry

7700 Folsom

Boulevard

(916) 388-3045

wwwsuttermedi

calcenterorg

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 53 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Hours of

Operation

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

65Fremont

Hospital

39001 Sundale

Drive

(510) 796-1100

wwwfremontho

spitalcom

24 hours

All ages

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 54 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

SUBSTANCE ABUSE SERVICES PROVIDER DIRECTORY

66 Central Intake

Unit

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-9600

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Substance Use Disorder

Assessment for

Outpatient amp Inpatient

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 55 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

67 Chemical

Dependency

Counseling Center

(CDCC)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-3720

Fax (209)468-

9611

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Youth

Adult

Perinatal

Spanish

Mon Wed and Fri

8am-5pm

Closed Holidays

Outpatient Treatment

Perinatal Component

Intensive Outpatient

Youth Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 56 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

68 Alcohol amp Drug

Alternative Program

(ADAP)

620 N Aurora St

Suite 1 Stockton

CA 95202

(209) 468-6840

Fax (209)468-

8640

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

Mon Wed and Fri

8am-5pm

Tue And Thur

8am-7pm

Closed Holidays

Outpatient Court

Monitoring Education

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 57 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

69 Family Ties

500 W Hospital Rd

French Camp CA

95231

(209) 468-6208

Fax (209)468-

7032

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult and

Adult

Perinatal

Spanish

24 Hour Services

Inpatient Treatment

Perinatal Component

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 58 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

70 Recovery House

500 W Hospital Rd

French Camp CA

95231

(209) 468-6857

Fax (209)468-

6739

httpwwwsjcb

hsorgProgram_

Locationsaspx

Adult

Spanish

24 Hour Services

Inpatient Treatment

Assessments

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 59 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

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

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Individual amp group

counseling and

education in conjunction

with the adolescentrsquos

mental health services a

partnership with Mental

Health Services and

Substance Abuse

Services

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 60 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

72 Prevention

Services

620 N Aurora St

Suite 6 Stockton

CA 95202

(209) 468-2005

Fax (209)468-

2251

httpwwwsjcb

hsorgProgram_

Locationsaspx

Youth

Spanish

Mon-Fri 8am-5pm

Closed Holidays

Youth Services Parenting

Students In Prevention

(SIP)

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 61 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

73 Aegis

Treatment Center

8626 N Lower

Sacramento Road

Suite 41 Stockton

CA 95209

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 62 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

74 5th Street

Medical Clinic

Stockton

1839 S El Dorado

St Stockton CA

95206

(209) 478-2487

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 63 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

75 Aegis

Treatment Center

Healthy Connections

(California St)

Stockton

1947 N California

St Suites B and C

Stockton CA 95210

(209) 463-0870

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 64 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

76 Healthy

Connections Lodi

Clinic

441 South Ham

Lane Suite A

Lodi CA 95242

(209) 224-8490

httpsaegistreat

mentcenterscom

clinicaegis-

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

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 65 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

77 Manteca

Healthy Connections

Center Street

955 W Center St

Suites 12A amp 14

Manteca CA 95337

(209) 239-9600

httpsaegistreat

mentcenterscom

clinicaegis-

manteca-

california

Adult and

Adult

Perinatal

Spanish

Mon-Fri

530am-1pm

Sat Sun and

Holidays

8am-11am

Medically Supervised

Methadone Maintenance

Detoxification (OTP)

Outpatient Treatment

(OTP) Medication

Assisted Treatment

Yes

Yes

Yes

San Joaquin County Behavioral Health Services

County and Contract Medi-Cal Providers

SJCBHS Medi-Cal Provider Directory_Rev122018 332018322018 Page 66 of 66

See Provider Staff Listing Non-English Languages as well as American Sign Language are available upon request

Providers

Provider Numbers

Address

Telephone

Website

Addresses

Popu-

lations

Served

Non-

English

Lang-

uages (in

addition

to free

Inter-

preter

Services)

Including

ASL

Provider

Characteristics

Cultural

Competency

Hours of

Operation

Medi-Cal Certified

Service Categories

Accept-

ing New

Clients

Com-

pleted

Cultural

Compe-

tency

Training

Accommo-

dations for

people

with Dis-

abilities

YesNo

YesNo

YesNo

78 MedMark

Treatment Center

1111 N El Dorado

St Stockton CA

95202

(209) 938-0228

httpmedmark

commedmark-

treatment-

centers-

stockton

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

Provider Name Facility NameID

Type of Practioner (licensed

amp Waivered)

National

Provider

Identifier

number California license number type of license

Cultu

ral

Comp

etenc

e

Traini

ng

(YN)1 Black

Awaremenss

Community

Outreach

ProgramMulti

cultural

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

Scott Harrison BHS BACOPMC Clinician II 1518089317 Marriage and Family Therapist Intern IMF75861 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

Provider Staff Listing

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

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

Debra Baker CATS OUTPATIENT 1836 Waivered 1740610229 AMFT 95836 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

Teri Jorgensen CATS OUTPATIENT 1836 Licensed 1295071363 RN 469034 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 Crisis

MD

1366560112 G70479

Y

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 CSU

MD

1366560112 G70479

Y

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 A49224

Y

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 N

26 Bright

House Robert 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 Roger Duke Child Abuse Prevention Council LMFT 1992861082 79588 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 390002DNAMFT Intern 1114346848 AMFT100257 Y

Lawrence Shaddix Chemical Dependency Counseling Center 390002DNMFT Intern 1508282286 IMF84560 Y

Robert Raymond Hart Chemical Dependency Counseling Center 390002DNPsychiatrist 1477660074 C38923 Y

Khurram Khan Durrani Chemical Dependency Counseling Center 390002DNPsychiatrist 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

Lawrence Shaddix Family Ties 390002EN MFT Intern 1508282286 IMF84560 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

Lawrence Shaddix Recovery House 390002AN MFT Intern 1508282286 IMF84560 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 ConnectionsMedical License 1212069758 G53561 Y

Melissa Whitworth Aegis Treatment CenterHealthy ConnectionsVocation Nurse RN 541037 Y

Dr Brian Talleur Aegis Treatment CenterHealthy ConnectionsMedical License 1659791101 A154190 Y

Alvin Goat Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 20473 Y

Crystal August Aegis Treatment CenterHealthy ConnectionsVocation Nurse VN 695962 Y

Rosenah Durago Aegis Treatment CenterHealthy ConnectionsVocation Nurse 1841629185 VN 235553 Y

Maria Garsuta Aegis Treatment CenterHealthy ConnectionsVocation 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 YDourine Iqiel Manteca Healthy Connections Vocation Nurse 1477008506 VN281162 YRebecca Mohr Manteca Healthy Connections Psyciatric Technician LPT 26531 Y

78 MedMark Treatment Center httpsmedmarkcommedmark-treatment-centers-stockton

LANGUAGE ASSISTANCE

English

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

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 )

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

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 1-866-735-2

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 تسهيلات 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 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) العربيةملحوظة 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)

  • 18-Font English Medi-Cal Provider Directory(Word Doc) 12-2018 English
  • Medi-Cal Directory Provider Staff Listing 18 font English 12-2018
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