NPIMap

Organization Active NPI

County of Stanislaus

  • Psychiatry Physician
  • Modesto, CA
National Provider Identifier
1750592184
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
COUNTY OF STANISLAUS
Practice address
800 Scenic Dr
Modesto, CA 95350-6131
Phone
(209) 525-6225
NPI assigned
May 25, 2007
Last updated
Jul 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
STANISLAUS COUNTY BHRSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Authorized official

Name
Ruben Imperial, MBA
Title
Behavioral Health Interim Director
Phone
(209) 525-6225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

800 Scenic Dr
Modesto, CA 95350-6131

Mailing address

800 Scenic Dr
Modesto, CA 95350-6131
Phone (209) 525-6225

Other identifiers 1

IdentifierTypeStateIssuer
5054MedicaidCA

Other names 1

  • FEE FOR SERVICE - PSYCHIATRIST Other name

National Provider Directory

National Provider Directory
Tax ID family
Stan Co Mentalhealth SV113 organizations share this tax ID, including this one
Part of
Stan Co Mentalhealth SV

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1750592184",
    "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": "209-525-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-525-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF STANISLAUS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STANISLAUS COUNTY BHRS",
        "enumeration_date": "2007-05-25",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "IMPERIAL",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH INTERIM DIRECTOR",
        "authorized_official_telephone_number": "209-525-6225",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5054",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FEE FOR SERVICE - PSYCHIATRIST",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "FEE FOR SERVICE - PSYCHIATRIST",
            "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 Jul 28, 2026; 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.