Phoenix Jett-Dias

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

3300 Tully Rd
Modesto, CA 95350-0836

Phone

(209) 585-0555

Fax

(209) 596-5142

NPI assigned

Jun 3, 2024

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other names 1

• Phoenix Jett-Dias Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hopenet Community Counseling a Licensed Clinical Social Worker Co

  • Clinical Social Worker
  • Modesto, CA
  • NPI 1992453922
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1114768280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 TULLY RD STE B6",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500848",
            "telephone_number": "209-585-0555",
            "fax_number": "209-596-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 TULLY RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500836",
            "telephone_number": "209-585-0555",
            "fax_number": "209-596-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETT-DIAS",
        "first_name": "PHOENIX",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2024-06-03",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHOENIX",
            "last_name": "JETT-DIAS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Emily Jeppesen
• Barbara A Jeppson
• John R Jeppson, D.D.S.
• Jerome a Robson M D Inc
• Jerome Richards MD Inc
• Jeffrey Jett, DO
• Francine Jew
• Harinder Jhatu, PA
• Jhsurgical Professional Corporation
• Weizheng Jiang, MD

• Student in an Organized Health Care Education/Training Program in Modesto, CA
• Providers in Modesto, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.