| High Risk Health & Senior Access | |
|
500 N 9th St Ste B Modesto CA 95350-5814 | |
| (209) 525-6225 | |
| Not Available |
| Full Name | High Risk Health & Senior Access |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 500 N 9th St Ste B, Modesto, California |
| Authorized Official Name and Position | Ruben Imperial (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 |
|---|---|
| High Risk Health & Senior Access 800 Scenic Dr Modesto CA 95350-6131 Ph: (209) 525-6225 | High Risk Health & Senior Access 500 N 9th St Ste B Modesto CA 95350-5814 Ph: (209) 525-6225 |
| NPI Number | 1154524445 |
|---|---|
| Provider Enumeration Date | 06/06/2007 |
| Last Update Date | 02/03/2022 |
| Certification Date | 02/03/2022 |
| Medicare PECOS PAC ID | 0648183996 |
|---|---|
| Medicare Enrollment ID | O20031111000935 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154524445 | NPI | - | NPPES |
| 5083 | Medicaid | CA | |
| 50BL | Medicaid | CA |
| 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 | 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 | Wamaitha Whidby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609084763 PECOS PAC ID: 5991095937 Enrollment ID: I20160603001803 |
| Provider Name | Kristie Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457656258 PECOS PAC ID: 5890052625 Enrollment ID: I20171208000293 |
| 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 |
| Provider Name | Amber Mae Grimme |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629628789 PECOS PAC ID: 2668832916 Enrollment ID: I20230718002130 |
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