OrganizationActive
County of Stanislaus
NPI 1760353155 · Prison Health Clinic/Center · Modesto, CA
Provider details
- NPI number
- 1760353155
- Entity type
- Organization
- Primary specialty
- Prison Health Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- County of Stanislaus
- Organization subpart
- Yes
- Authorized official
- Marisol Marin, Calaim Transformation Manager(209) 652-3805
Specialties & taxonomies
Ambulatory Health Care Facilities
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Practice location
2215 Blue Gum Ave
Modesto, CA 95358-1052
Phone: (209) 652-3805
Fax: (209) 652-3805
Approximate (ZIP-level) locationGet directions
Mailing address
2215 Blue Gum Ave
Modesto, CA 95358-1052
Registry dates
- Enumerated
- 2025-09-17
- Last updated
- 2025-11-06
- Certified
- 2025-11-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.