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General NPI Number Information
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NPI Number | 1134699218
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Entity Type | Individual
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Provider Name | MICHAEL THEY NP
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Gender | Male
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 1608 TULLY RD
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City | MODESTO
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State | CA
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Zip | 95350-4031
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Country | US
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Telephone | 866-240-8517
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Fax | 209-497-8337
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Provider Business Mailing Address
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Address Line | PO BOX 578688
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City | MODESTO
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State | CA
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Zip | 95357-8688
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Country | US
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Telephone | 866-240-8517
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Fax | 209-497-8337
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP95010524
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WP0000X
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Taxonomy Name | Pain Management Registered Nurse
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License Number | NP95010524
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95010524
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License Number State | CA
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