NPIMap

Organization Active NPI

Legacy Alliance Outreach

  • Peer Specialist
  • Modesto, CA
National Provider Identifier
1619708229
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
LEGACY ALLIANCE OUTREACH
Practice address
820 H St
Modesto, CA 95354-3419
Phone
(209) 480-6199
NPI assigned
Aug 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Alexander Bequette
Title
Program Director
Phone
(925) 784-0386

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

820 H St
Modesto, CA 95354-3419

Mailing address

2601 Oakdale Rd Ste 154
Modesto, CA 95355-2256
Phone (209) 480-6199

National Provider Directory

National Provider Directory
Tax ID family
Legacy Alliance Outreach3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1619708229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 OAKDALE RD STE 154",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953552256",
            "telephone_number": "209-480-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 H ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953543419",
            "telephone_number": "209-480-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY ALLIANCE OUTREACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "BEQUETTE",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "925-784-0386"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "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 Aug 13, 2024; 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.