NPIMap

Organization Active NPI

Stanislaus County BHRS

  • Community/Behavioral Health Agency
  • Modesto, CA
National Provider Identifier
1457480642
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
STANISLAUS COUNTY BHRS
Practice address
1301 G St
Modesto, CA 95354-2421
Phone
(209) 525-7423
NPI assigned
Mar 5, 2007
Last updated
Nov 4, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
STANISLAUS COUNTY BHRSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Authorized official

Name
Richard Degette, MFT
Title
Behavioral Health Director
Phone
(209) 525-6225

Specialties & licenses 1

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

Addresses

Primary practice location

1301 G St
Modesto, CA 95354-2421

Mailing address

800 Scenic Dr
Modesto, CA 95350-6131
Phone (209) 525-6885

Other identifiers 3

IdentifierTypeStateIssuer
BV659BMedicaidCA
50A8MedicaidCA
ZZZ06630ZOtherMEDICARE

Other names 1

  • MHSA HEALTH/MENTAL HEALTH TEAM Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000935 CA Part B Supplier - Clinic/Group Practice 0648183996 Receives reassigned benefits from 24 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ceres, CA; Modesto, CA; Turlock, CA

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Part of
Stanislaus Medical Cent

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478217600000",
    "number": "1457480642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-525-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 G ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542421",
            "telephone_number": "209-525-7423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANISLAUS COUNTY BHRS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STANISLAUS COUNTY BHRS",
        "enumeration_date": "2007-03-05",
        "last_updated": "2016-11-04",
        "status": "A",
        "authorized_official_last_name": "DEGETTE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "209-525-6225",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BV659B",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50A8",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "ZZZ06630Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MHSA HEALTH/MENTAL HEALTH TEAM",
            "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 Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.