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NPI 1750772653

NPI 1750772653 : GREGORY TOPETE : MODESTO, CA

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General NPI Number Information
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    NPI Number           |    1750772653
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    Entity Type          |    Individual 
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    Provider Name        |    GREGORY TOPETE
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/12/2015
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    Last Update Date     |    02/13/2015
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Provider Practice Location Address
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    Address Line         |    1235 MCHENRY AVE STE A 
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    City                 |    MODESTO
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    State                |    CA
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    Zip                  |    95350-5370
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    Country              |    US
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    Telephone            |    209-527-4597
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8717 WILSON ST 
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    City                 |    PATTERSON
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    State                |    CA
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    Zip                  |    95363-9558
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    Country              |    US
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    Telephone            |    209-996-4066
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    Fax                  |    
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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        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    
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    License Number State |    
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