Active NPI
Andrew Modrich
- Health & Wellness Coach
- Vallejo, CA
National Provider Identifier
1457237331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- License
- 968AED3373
- Practice address
- 815 Cedar St
Vallejo, CA 94591-6531 - Phone
- (707) 556-8640
- NPI assigned
- Aug 14, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | |||
| Health & Wellness Coach | 171400000X | 968AED3373 | CA | Primary |
Addresses
Primary practice location
815 Cedar St
Vallejo, CA 94591-6531
Mailing address
815 Cedar St
Vallejo, CA 94591-6531
Phone (707) 556-8640
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
| License | State | Type | Specialty |
|---|---|---|---|
| 968AED3373 | CA | MD | Health & Wellness Coach |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755129600000",
"number": "1457237331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 CEDAR ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945916531",
"telephone_number": "707-556-8640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 CEDAR ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945916531",
"telephone_number": "707-556-8640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODRICH",
"first_name": "ANDREW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-14",
"last_updated": "2025-08-14",
"certification_date": "2025-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": "CA",
"license": "968AED3373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.