Individual provider Active NPI

Jesus Gaytan Ascencio

  • Adult Companion
  • Modesto, CA
National Provider Identifier
1245358530
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
Practice address
2215 Blue Gum Ave
Modesto, CA 95358-1052
Phone
(209) 525-5401
Fax
(209) 525-5498
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X CA Primary

Addresses

Primary practice location

2215 Blue Gum Ave
Modesto, CA 95358-1052

Mailing address

2118 Tucson Ave
Modesto, CA 95358-5944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1245358530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 TUCSON AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953585944"
        },
        {
            "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": "209-525-5401",
            "fax_number": "209-525-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASCENCIO",
        "first_name": "JESUS",
        "middle_name": "GAYTAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 15, 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.