Healthcare Provider Details

I. General information

NPI: 1154682441
Provider Name (Legal Business Name): SATELLITE HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2012
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4207 BANGS AVE SUITE 100
MODESTO CA
95356-8714
US

IV. Provider business mailing address

300 SANTANA ROW SUITE 300
SAN JOSE CA
95128-2424
US

V. Phone/Fax

Practice location:
  • Phone: 209-338-2500
  • Fax: 209-543-3840
Mailing address:
  • Phone: 209-338-2500
  • Fax: 650-625-6007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BERNADETTE VINCENT
Title or Position: PRESIDENT/COO
Credential:
Phone: 650-404-3600