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General NPI Number Information
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NPI Number | 1992909378
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Entity Type | Organization
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Legal Business Name | COUNTY OF STANISLAUS
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 500 N 9TH ST STE C
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City | MODESTO
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State | CA
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Zip | 95350-5814
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Country | US
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Telephone | 209-558-4420
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Fax |
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Provider Business Mailing Address
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Address Line | 800 SCENIC DR
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City | MODESTO
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State | CA
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Zip | 95350-6131
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Country | US
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Telephone | 209-558-6225
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Fax |
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Authorized Official
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Title or Position | BEHAVIORAL HEALTH DIRECTOR
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Name | RUBEN IMPERIAL
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Credential | MBA
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Telephone | 209-525-6225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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