County Of Stanislaus
Clinic/Center, Prison Health in Modesto, CA. Organization (NPI-2).
NPI number1760353155
StatusActive
Last updated in NPPESNov 6, 2025
Details
- NPI
- 1760353155
- Entity type
- Organization (NPI-2)
- Legal business name
- County Of Stanislaus
- Organization subpart
- Yes
- Enumeration date
- Sep 17, 2025
- Certification date
- Nov 6, 2025
- Last updated
- Nov 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2400X | Clinic/Center, Prison Health | – | – | Yes |
| 261Q00000X | Clinic/Center | – | – |
Practice location
2215 Blue Gum AveModesto, CA 95358-1052
Phone 209-652-3805 · Fax 209-652-3805
Mailing address
2215 Blue Gum AveModesto, CA 95358-1052
Phone 209-652-3805 · Fax 209-652-3805
Authorized official
Marisol Marin
Calaim Transformation Manager
2096523805
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