OrganizationActive
Active Change Recovery Inc
NPI 1508648163 · Case Management Agency · Stockton, CA
Provider details
- NPI number
- 1508648163
- Entity type
- Organization
- Primary specialty
- Case Management AgencyAgencies
- Organization subpart
- No
- Authorized official
- Martin Sisneroz, Ceo(559) 250-1121
Specialties & taxonomies
Agencies
Ambulatory Health Care Facilities
- Community/Behavioral Health Agency251S00000X
Agencies
- Substance Abuse Rehabilitation Facility324500000X
Residential Treatment Facilities
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
8 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
229 E Weber Ave Ste 103
Stockton, CA 95202-2751
Phone: (209) 921-0971
Street-level locationGet directions
Mailing address
1738 Bartlett Ct
Stockton, CA 95206-6358
Additional practice locations (7)
- 1910 Geneva DrModesto, CA 95350-2824Phone: (209) 921-0971
- 1894 Gordon Verner CirStockton, CA 95206-6138Phone: (559) 250-1121
- 1823 Erickson CirStockton, CA 95206-6355Phone: (559) 250-1121
- 1738 Bartlett CtStockton, CA 95206-6358Phone: (209) 921-0971
- 3541 Tom LnStockton, CA 95206-6140Phone: (209) 921-0971
- 8428 Hamilton WayStockton, CA 95209-2215Phone: (209) 921-0971
- 3319 Estate DrStockton, CA 95209-5152Phone: (209) 921-0971
Registry dates
- Enumerated
- 2023-10-18
- Last updated
- 2026-01-13
- Certified
- 2026-01-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.