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Organization
STANISLAUS COUNTY
Active
Organization
STANISLAUS COUNTY
Active
Other names
FEE FOR SERVICE - MIXED SPECIALTY GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE C HUNT RN,MFT (BEHAVIORAL HEALTH DIRECTOR)
(209) 525-6225
Entity
Organization
Contact information
Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 558-4752
Mailing address
800 SCENIC DR, MODESTO, CA 95350-6131
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5059
—
CA
Enumeration date
05/25/2007
Last updated
08/22/2020
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