Healthcare Provider Details

I. General information

NPI: 1043536246
Provider Name (Legal Business Name): MISS DEALLY S. CURRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N 9TH ST STE D
MODESTO CA
95350-5814
US

IV. Provider business mailing address

800 SCENIC DR BLDG 5
MODESTO CA
95350-6131
US

V. Phone/Fax

Practice location:
  • Phone: 209-380-6204
  • Fax: 209-558-4321
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberASW114158
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: