Healthcare Provider Details

I. General information

NPI: 1144310657
Provider Name (Legal Business Name): VALLEY HAND CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ROSEBURG AVE STE B-1
MODESTO CA
95350-5200
US

IV. Provider business mailing address

200 W ROSEBURG AVE STE B-1
MODESTO CA
95350-5200
US

V. Phone/Fax

Practice location:
  • Phone: 209-575-2344
  • Fax: 209-575-2340
Mailing address:
  • Phone: 209-575-2344
  • Fax: 209-575-2340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG842150
License Number StateCA

VIII. Authorized Official

Name: DR. TERESA AIMEE SCHULLY
Title or Position: PHYSICIAN/OWNER
Credential: M.D.
Phone: 209-575-2344