Healthcare Provider Details

I. General information

NPI: 1740129683
Provider Name (Legal Business Name): MARIA MAY ASC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 SYLVAN AVE
MODESTO CA
95355-7893
US

IV. Provider business mailing address

1668 AUDREY LN
RIPON CA
95366-8221
US

V. Phone/Fax

Practice location:
  • Phone: 209-574-1729
  • Fax:
Mailing address:
  • Phone: 209-400-0124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: