Healthcare Provider Details

I. General information

NPI: 1932762424
Provider Name (Legal Business Name): MS. VIRGINIA M. SIGALA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2019
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SCENIC DR BLDG A
MODESTO CA
95350-6131
US

IV. Provider business mailing address

800 SCENIC DR BLDG A
MODESTO CA
95350-6131
US

V. Phone/Fax

Practice location:
  • Phone: 209-525-4982
  • Fax:
Mailing address:
  • Phone: 209-525-4982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number405300000X
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-LBEZIO
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: