Individual
CHARLES, FREDERICK MATTHEW INSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 525-7339
Mailing address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 525-7339
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
CA
372600000X
Adult Companion
Primary
CI37320123
CA
374700000X
Technician
—
—
Other
Enumeration date
11/13/2020
Last updated
05/16/2025
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