Provider Demographics
NPI:1205458288
Name:A STEP FORWARD, A PATH TO WELLNESS
Entity type:Organization
Organization Name:A STEP FORWARD, A PATH TO WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:JIMENEZ
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA
Authorized Official - Phone:209-406-7665
Mailing Address - Street 1:875 GEER RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-3311
Mailing Address - Country:US
Mailing Address - Phone:209-406-7665
Mailing Address - Fax:209-633-3031
Practice Address - Street 1:2111 GEER RD STE 504
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2472
Practice Address - Country:US
Practice Address - Phone:209-406-7665
Practice Address - Fax:209-633-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty