Healthcare Provider Details

I. General information

NPI: 1437860467
Provider Name (Legal Business Name): JUHI PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 MCHENRY AVE STE 100
MODESTO CA
95350-4534
US

IV. Provider business mailing address

2655 HENLEY PKWY UNIT 8612
TRACY CA
95377-2241
US

V. Phone/Fax

Practice location:
  • Phone: 209-579-2300
  • Fax:
Mailing address:
  • Phone: 912-223-4784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN316766
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95424789
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberGA316766
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95036138
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: