Healthcare Provider Details

I. General information

NPI: 1861463770
Provider Name (Legal Business Name): SATELLITE HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 COFFEE RD STE 21
MODESTO CA
95355-1315
US

IV. Provider business mailing address

300 SANTANA ROW STE 300
SAN JOSE CA
95128-2423
US

V. Phone/Fax

Practice location:
  • Phone: 209-578-0691
  • Fax: 209-578-4479
Mailing address:
  • Phone: 209-578-0691
  • Fax: 650-625-6008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number110000447
License Number StateCA

VIII. Authorized Official

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