Individual provider Active NPI

Estela Moreno, ADULT COMPANION

  • Student in an Organized Health Care Education/Training Program
  • Modesto, CA
National Provider Identifier
1306501739
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1700 McHenry Village Way
Modesto, CA 95350-4308
Phone
(209) 550-5850
NPI assigned
Nov 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X CA
Student in an Organized Health Care Education/Training Program 390200000X CA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CA
Addiction (Substance Use Disorder) Counselor 101YA0400X 10429 CA

Addresses

Primary practice location

1700 McHenry Village Way
Modesto, CA 95350-4308

Mailing address

2112 Floyd Ave Apt 2
Modesto, CA 95355-2239
Phone (209) 505-0632

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

State licenses

LicenseStateTypeSpecialty
10429CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1306501739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 FLOYD AVE APT 2",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552239",
            "telephone_number": "209-505-0632",
            "fax_number": "209-505-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MCHENRY VILLAGE WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504308",
            "telephone_number": "209-550-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "ESTELA",
        "credential": "ADULT COMPANION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "10429",
            "primary": false
        }
    ],
    "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 Aug 31, 2026; 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.