NPIMap

Organization Active NPI

County of Stanislaus

  • Clinic/Center
  • Modesto, CA
National Provider Identifier
1891991741
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COUNTY OF STANISLAUS
Practice address
830 Scenic Dr
Ste a
Modesto, CA 95350-6131
Phone
(209) 558-8400
Fax
(209) 558-8611
NPI assigned
Jun 26, 2007
Organization subpart
Yes
Parent organization
STANISLAUS COUNTY HEALTH SERVICES AGENCYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Authorized official

Name
Heather Duvall
Title
Managing Director
Phone
(209) 558-7163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

830 Scenic Dr
Ste a
Modesto, CA 95350-6131

Mailing address

830 Scenic Dr
Ste a
Modesto, CA 95350-6131
Phone (209) 558-8400

Other identifiers 3

IdentifierTypeStateIssuer
FHC70757FOtherCAMEDICAL
CMM70757FOtherCAMEDICAL
HAP70757FOtherCAFAMILY PACT

Other names 1

  • Stanislaus County Health Services Agency Pediatrics Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031111000939 CA Part B Supplier - Clinic/Group Practice 0648183996 Receives reassigned benefits from 59 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Modesto, CA; Ceres, CA
O20071016000364 CA Part A Provider - Federally Qualified Health Center (FQHC) 0648183996 Practice locations: Modesto, CA

Federally qualified health center certification: CCN 051122

Legal name
COUNTY OF STANISLAUS
Doing business as
STANISLAUS COUNTY HEALTH SERVICES AGENCY FAMILY & PEDIATRIC HEALTH CEN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 7, 2007
Last certification
Nov 7, 2007
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
830 Scenic Drive
Suite a
Modesto, CA 95350-6133

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Scenic Medical Group

Locations

830 Scenic Dr
Ste A
Modesto, CA 95350
Phone (209) 558-7000

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
County of Stanislaus Organization, Modesto, CA Operational/Managerial Control Sep 20, 2007
Heather Duvall Individual Corporate Director Apr 1, 2025
W-2 Managing Employee Apr 1, 2025

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Stanislaus County Health Services Agency McHenry Medical OfficeModesto, CA, CCN 051121 Federally qualified health center Operational/Managerial Control Sep 20, 2007
Stanislaus County Health Services Agency Paradise Medical OfficeModesto, CA, CCN 051117 Federally qualified health center Operational/Managerial Control Sep 20, 2007

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1891991741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 SCENIC DR",
            "address_2": "STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-558-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 SCENIC DR",
            "address_2": "STE A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506131",
            "telephone_number": "209-558-8400",
            "fax_number": "209-558-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF STANISLAUS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STANISLAUS COUNTY HEALTH SERVICES AGENCY",
        "enumeration_date": "2007-06-26",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "DUVALL",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "209-558-7163"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "FHC70757F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "CMM70757F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PACT",
            "identifier": "HAP70757F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanislaus County Health Services Agency Pediatrics Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.