MEDICARE: STANISLAUS COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962534925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STANISLAUS COUNTY

Provider Business Mailing Address
First Line	:	800 SCENIC DR
Second Line	:
City	:	MODESTO
State	:	CA
Zip	:	95350-6131
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1171 7TH AVE
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-2714
Country	:	US
Telephone Number	:	209-525-7423
Fax Number	:

Authorized Official
Title or Position	:	BEHAVIORAL HEALTH DIRECTOR
Name	:	DENISE C HUNT
Credential	:	RN, MFT
Telephone Number	:	209-525-6225

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	08/22/2020

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Directions to “STANISLAUS COUNTY ” Practice Location

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