Healthcare Provider Details

I. General information

NPI: 1376735282
Provider Name (Legal Business Name): SIERRA VISTA CHILD & FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 2
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: 209-252-0419