Healthcare Provider Details

I. General information

NPI: 1518364504
Provider Name (Legal Business Name): NORTH MODESTO FAMILY RESOURCE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2014
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 STANDIFORD AVE SUITE C1
MODESTO CA
95350-6529
US

IV. Provider business mailing address

1600 N CARPENTER RD STE B
MODESTO CA
95351-1185
US

V. Phone/Fax

Practice location:
  • Phone: 209-338-0279
  • Fax:
Mailing address:
  • Phone: 209-523-4573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: STACEY SILVEIRA
Title or Position: DIRECTOR OF QUALITY ASSURANCE
Credential:
Phone: 209-523-4610