Active NPI
County of Stanislaus
- Prison Health Clinic/Center
- Modesto, CA
National Provider Identifier
1760353155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prison Health Clinic/Center
- Legal business name
- COUNTY OF STANISLAUS
- Practice address
- 2215 Blue Gum Ave
Modesto, CA 95358-1052 - Phone
- (209) 652-3805
- Fax
- (209) 652-3805
- NPI assigned
- Sep 17, 2025
- Organization subpart
- Yes
- Parent organization
- COUNTY OF STANISLAUS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marisol Marin
- Title
- Calaim Transformation Manager
- Phone
- (209) 652-3805
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Prison Health Clinic/Center | 261QP2400X | Primary |
Addresses
Primary practice location
2215 Blue Gum Ave
Modesto, CA 95358-1052
Mailing address
2215 Blue Gum Ave
Modesto, CA 95358-1052
Phone (209) 652-3805
National Provider Directory
National Provider Directory- Part of
- County of Stanislaus
Locations
2215 Blue Gum Ave
Modesto, CA 95358
Phone (209) 525-5401
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758067200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762387200000",
"number": "1760353155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 BLUE GUM AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953581052",
"telephone_number": "209-652-3805",
"fax_number": "209-652-3805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 BLUE GUM AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953581052",
"telephone_number": "209-652-3805",
"fax_number": "209-652-3805"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF STANISLAUS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COUNTY OF STANISLAUS",
"enumeration_date": "2025-09-17",
"last_updated": "2025-11-06",
"certification_date": "2025-11-06",
"status": "A",
"authorized_official_last_name": "MARIN",
"authorized_official_first_name": "MARISOL",
"authorized_official_title_or_position": "CALAIM TRANSFORMATION MANAGER",
"authorized_official_telephone_number": "209-652-3805"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Prison Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
- County of Stanislaus (Stanislaus County Health Services Agency Rehabilitation Department)
- County of Stanislaus
- County of Stanislaus
- County of Stanislaus (Children's Mobile Assessment Team)
- County of Stanislaus
- County of Stanislaus (Health Services Agency ECM)
- County of Stanislaus
- County of Stanislaus (Stanislaus County Behavioral Health and Recovery Services)
- County of Stanislaus
- County of Stanislaus (Behavioral Health Wellness Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.