NPIMap

Organization Active NPI

County of Stanislaus

  • Community/Behavioral Health Agency
  • Modesto, CA
National Provider Identifier
1174651236
Registry record updated Mar 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNTY OF STANISLAUS
Practice address
2215 Blue Gum Ave
Modesto, CA 95358-1052
Phone
(209) 525-6225
NPI assigned
Mar 1, 2007
Organization subpart
Yes
Parent organization
COUNTY OF STANISLAUSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 10, 2022

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

Authorized official

Name
Ruben Imperial, MBA
Title
Behavioral Health Director
Phone
(209) 525-6225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2215 Blue Gum Ave
Modesto, CA 95358-1052

Mailing address

800 Scenic Drive
BLDG. 4
Modesto, CA 95350-6131
Phone (209) 525-6225

Other identifiers 1

IdentifierTypeStateIssuer
5048MedicaidCA

Other names 1

  • Juvenile Justice - CSOC Other name

National Provider Directory

National Provider Directory
Tax ID family
Scenic Medical Group113 organizations share this tax ID, including this one
Part of
Scenic Medical Group

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1174651236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SCENIC DRIVE",
            "address_2": "BLDG. 4",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-525-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 BLUE GUM AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953581052",
            "telephone_number": "209-525-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF STANISLAUS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF STANISLAUS",
        "enumeration_date": "2007-03-01",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "IMPERIAL",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH  DIRECTOR",
        "authorized_official_telephone_number": "209-525-6225",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5048",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Juvenile Justice - CSOC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Juvenile Justice - CSOC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.