Healthcare Provider Details

I. General information

NPI: 1518041144
Provider Name (Legal Business Name): BEATRICE ST CLAIRE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

1335 MAGNOLIA AVE
MODESTO CA
95350-5249
US

V. Phone/Fax

Practice location:
  • Phone: 209-558-4598
  • Fax:
Mailing address:
  • Phone: 209-876-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG69391
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: