| Adult Medication Clinic | |
|
500 N 9th St Ste A Modesto CA 95350-5814 | |
| (209) 558-4598 | |
| Not Available |
| Full Name | Adult Medication Clinic |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 500 N 9th St Ste A, Modesto, California |
| Authorized Official Name and Position | Tony Vartan (BEHAVIORAL HEALTH DIRECTOR) |
| Authorized Official Contact | 2095256225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult Medication Clinic 800 Scenic Dr Modesto CA 95350-6131 Ph: (209) 525-6225 | Adult Medication Clinic 500 N 9th St Ste A Modesto CA 95350-5814 Ph: (209) 558-4598 |
| NPI Number | 1023681301 |
|---|---|
| Provider Enumeration Date | 07/23/2021 |
| Last Update Date | 10/14/2022 |
| Certification Date | 10/14/2022 |
| Medicare PECOS PAC ID | 0648183996 |
|---|---|
| Medicare Enrollment ID | O20041108000570 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023681301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Teresa Crisostomo Raras |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962572743 PECOS PAC ID: 8820057151 Enrollment ID: I20041004000512 |
| Provider Name | Purificacion-hency Marquez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457303232 PECOS PAC ID: 0244149730 Enrollment ID: I20041014000687 |
| Provider Name | Jonathan A Kistler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033161740 PECOS PAC ID: 7214980424 Enrollment ID: I20050228001070 |
| Provider Name | Beatrice M St Claire |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518041144 PECOS PAC ID: 3375635519 Enrollment ID: I20070817000477 |
| Provider Name | Naiyar U Zaman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558383380 PECOS PAC ID: 0648286518 Enrollment ID: I20100430000608 |
| Provider Name | Ashok Rao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982773354 PECOS PAC ID: 1951584739 Enrollment ID: I20110401000096 |
| Provider Name | Seniora A Mathews |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104977875 PECOS PAC ID: 7315921665 Enrollment ID: I20110429000269 |
| Provider Name | Elmer P Ignacio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578507604 PECOS PAC ID: 9638344351 Enrollment ID: I20111208000251 |
| Provider Name | Nataliya Giagou |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285854216 PECOS PAC ID: 4284888975 Enrollment ID: I20130205000232 |
| Provider Name | Kristie Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457656258 PECOS PAC ID: 5890052625 Enrollment ID: I20171208000293 |
| Provider Name | Kwame Buabeng |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316387673 PECOS PAC ID: 8628486636 Enrollment ID: I20210412001894 |
| Provider Name | Cassandra Pacheco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649529264 PECOS PAC ID: 5294113833 Enrollment ID: I20220609001818 |
| Provider Name | Maria T Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992838569 PECOS PAC ID: 7618356130 Enrollment ID: I20220614000304 |
| Provider Name | Thomasean Britten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790195386 PECOS PAC ID: 3072730662 Enrollment ID: I20220929001759 |
| Provider Name | Sarah T Vann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942338389 PECOS PAC ID: 2163898263 Enrollment ID: I20221020000915 |
| Provider Name | Teilor Ann Garner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811445901 PECOS PAC ID: 1951776970 Enrollment ID: I20230405001103 |
| Provider Name | Gurpreet S Ahluwalia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164452272 PECOS PAC ID: 0941220941 Enrollment ID: I20230419001562 |
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