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1868 E.Hazelton Ave. •Stockton, CA 95205-6232 •Phone (209)468-3420 <br />Jasjit Kang, R.E.H.S., Director <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE - PE 4520 - PRIMARY CARE FACILITY <br />Permit ID # PT0028121 for Record ID # PR0546981 <br />Valid From 1/1/2021 To 12/31/2021 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s) Valid only for: <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />KAISER FOUNDATION HEALTH PLAN INC <br />Regulated Facility: <br />17000 S HARLAN RD <br />LATHROP CA 95330 <br />Facility ID <br />Account ID <br />Issued <br />FA0026620 <br />AR0050682 <br />6/29/2021 <br />KAISER PERMANENTE - LATHROP BEHAVORIAL HEALTH <br />ATTN : EVS DEPTBilling Address: <br />KAISER PERMANENTE - LATHROP BEHAVORIAL <br />HEALTH1779 W YOSEMITE AVE STE 206 <br />MANTECA CA 95337 <br />7027.rpt End of Report