NPIMap

Organization Active NPI

Central Valley Pain Management and Wellness Clinic Inc

  • Non-Pharmacy Dispensing Site
  • Modesto, CA
National Provider Identifier
1497134969
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
A51949 Issued in CA
Legal business name
CENTRAL VALLEY PAIN MANAGEMENT AND WELLNESS CLINIC INC
Practice address
1300 Mable Ave # Suiteb2
Modesto, CA 95355-1120
Phone
(813) 448-3848
NPI assigned
May 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Authorized official

Name
Ariana Bedoya
Title
Credentialing Specialist
Phone
(813) 448-3848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X A51949 CA Primary

Addresses

Primary practice location

1300 Mable Ave # Suiteb2
Modesto, CA 95355-1120

Mailing address

311 Park Place Blvd FL 5
Clearwater, FL 33759-4904

National Provider Directory

National Provider Directory
Tax ID family
Central Valley Pain4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1300 Mable Ave
#2
Modesto, CA 95355
Phone (209) 448-3000

NPI Registry JSON

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1497134969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PARK PLACE BLVD FL 5",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MABLE AVE # SUITEB2",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551120",
            "telephone_number": "813-448-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL VALLEY PAIN MANAGEMENT AND WELLNESS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-29",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "BEDOYA",
        "authorized_official_first_name": "ARIANA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "813-448-3848"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A51949",
            "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 29, 2015; 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.