Healthcare Provider Details

I. General information

NPI: 1659233799
Provider Name (Legal Business Name): CHRISTINE TERESA MCDOWELL MA, PPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 LAS VEGAS ST
MODESTO CA
95358-5500
US

IV. Provider business mailing address

1592 VAN ANDEL WAY
RIPON CA
95366-9474
US

V. Phone/Fax

Practice location:
  • Phone: 209-574-1794
  • Fax: 209-574-1795
Mailing address:
  • Phone: 209-574-1794
  • Fax: 209-574-1795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA576453
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: