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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E.Hazelton Ave•Stockton,CA 95205-6232•Phone(209)468-3420 <br /> Jasjit Kang,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - PE 4520-PRIMARY CARE FACILITY <br /> Permit ID# PT0028121 for Record ID# PR0546981 <br /> Valid From 1/1/2023 To 12/31/2023 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: KAISER FOUNDATION HEALTH PLAN INC <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: KAISER PERMANENTE - LATHROP BEHAVIORAL HEALTH Facility ID FA0026620 <br /> 17000 S HARLAN RD Account ID AR0050682 <br /> LATHROP CA 95330 Issued 11/29/2022 <br /> Billing Address: ATTN : EVS DEPT <br /> KAISER PERMANENTE - BEHAVIORAL HEALTH <br /> 1779 W YOSEMITE AVE YOSEMITE BLDG STE 206 <br /> MANTECA CA 95337 <br /> 7027.rpt End of Report <br />