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Organization

COUNTY OF STANISLAUS

Active
Parent organization
COUNTY OF STANISLAUS
Organization subpart
Yes

Provider details

NPI number
Legal business name
COUNTY OF STANISLAUS
Authorized official
MARISOL MARIN (CALAIM TRANSFORMATION MANAGER)
(209) 652-3805
Entity
Organization

Contact information

Practice address
2215 BLUE GUM AVE, MODESTO, CA 95358-1052
(209) 652-3805
(209) 652-3805
Mailing address
2215 BLUE GUM AVE, MODESTO, CA 95358-1052
(209) 652-3805
(209) 652-3805

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
261QP2400X
Prison Health Clinic/Center
Primary

Other

Enumeration date
09/17/2025
Last updated
11/06/2025
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