Boys & Girls Clubs of Stanislaus County

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

BOYS & GIRLS CLUBS OF STANISLAUS COUNTY

Practice address

819 17TH St
Modesto, CA 95354-1250

Phone

(209) 222-5826

NPI assigned

Aug 27, 2025

Last updated

Aug 27, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jeremy James Martinez, MPA, CCMC

Title

Ceo

Phone

(209) 222-5826

Specialties & licenses 4

Addresses

Other names 1

• Boys & Girls Clubs of Stanislaus County Former legal business name

Locations

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1598644304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 17TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541250",
            "telephone_number": "209-222-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 17TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541250",
            "telephone_number": "209-222-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS & GIRLS CLUBS OF STANISLAUS COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-222-5826",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPA, CCMC"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boys & Girls Clubs of Stanislaus County",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sandra L. Boyd, O.D.
• Michael R Boyer, DDS
• Rochelle Boyer, SUDCC III
• Saralynn Boyer, OTR/L
• Amy Marie Boylan-Mendes
• Jafar Bozorgmehr, MD
• BR Translink Inc
• Paul J Braaton, MD
• Marissa Sari Bracamonte
• Alessandra Giselle Bracho-Soto

• Supports Brokerage Agency in Modesto, CA
• Providers in Modesto, CA by specialty
• Supports Brokerage Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.