Phoenix Jett-Dias
Student in an Organized Health Care Education/Training Program in Modesto, CA. Individual provider (NPI-1).
NPI number1114768280
StatusActive
Last updated in NPPESJul 25, 2025
Details
- NPI
- 1114768280
- Entity type
- Individual (NPI-1)
- Name
- Phoenix Jett-Dias
- Sole proprietor
- Yes
- Enumeration date
- Jun 3, 2024
- Certification date
- Jul 25, 2025
- Last updated
- Jul 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 174400000X | Specialist | – | – | |
| 175T00000X | Peer Specialist | – | – | |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Other names
- Phoenix Jett-Dias (Other Name)
Practice location
3300 Tully RdModesto, CA 95350-0836
Phone 209-585-0555 · Fax 209-596-5142
Mailing address
3300 Tully Rd Ste B6Modesto, CA 95350-0848
Phone 209-585-0555 · Fax 209-596-5142
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Student in an Organized Health Care Education/Training Program providers in Modesto, CA
- Zainab Akmal Abbasi, MBBSNPI 1972442903
- Arya Moussay AfzaliNPI 1841975646
- Natalie Aguilar VazquezNPI 1811722630
- Sofia Aguilar-PimentelNPI 1780197913
- Rahimot AkindeleNPI 1790570422
- Sultana Akter, MDNPI 1881534717
- Khalid Al Zubaidi, MDNPI 1023957032
- Zaid Alazawi, DONPI 1295583102
- Zahraa Ali AkbarNPI 1124967815
- Mohib Muhammad AliNPI 1801690755
All 309 Student in an Organized Health Care Education/Training Program providers in Modesto · All 10,803 providers in Modesto
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.