Healthcare Provider Details

I. General information

NPI: 1023462181
Provider Name (Legal Business Name): GENE RICHARD RADINO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: NEW HOPE RECOVERY

II. Dates (important events)

Enumeration Date: 04/14/2016
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 E ORANGEBURG AVE
MODESTO CA
95350-4619
US

IV. Provider business mailing address

220 STANDIFORD AVE SUITE F
MODESTO CA
95350-1159
US

V. Phone/Fax

Practice location:
  • Phone: 209-527-9797
  • Fax: 209-527-2007
Mailing address:
  • Phone: 209-579-5628
  • Fax: 209-579-5637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: