St Pauls Modesto LP

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

ST PAULS MODESTO LP

Practice address

2325 St Pauls Way
Modesto, CA 95355-3309

Phone

(209) 491-0800

NPI assigned

Oct 22, 2020

Organization subpart

No

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

Authorized official

Name

Deepak Israni

Title

Owner

Phone

(619) 296-9000

Specialties & licenses 1

Addresses

Other names 1

• Pacifica Senior Living Modesto Doing business as

Locations

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1689273401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 ST PAULS WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553309",
            "telephone_number": "209-491-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 ST PAULS WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553309",
            "telephone_number": "209-491-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PAULS MODESTO LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "ISRANI",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-296-9000"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacifica Senior Living Modesto",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daljit Kaur Srai, O.D.
• Chaithra Sreenath, MD
• Mahathep Matthew Srikureja, D.O.
• Sol Srouji, CRNFA
• Beatrice St Claire, M.D.
• Theodore Edmund Staahl, M.D.
• Thuy Staats, NP
• Claudia Stacey
• James Dean Stalians, AGNP
• Bonnie Sue Stallings

• Alzheimer Center (Dementia Center) in Modesto, CA
• Providers in Modesto, CA by specialty
• Alzheimer Center (Dementia Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; 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.