NPI Details
STANISLAUS COUNTY is a psychologist in Modesto, CA. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. STANISLAUS COUNTY NPI is 1538360722. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Fee For Service - Psychologist.
The provider's business location address is:
800 SCENIC DR
MODESTO, CA
ZIP 95350-131
Phone: (209) 558-4752
The provider's authorized official is Ruben Imperial .
The authorized official title is Behavioral Health Interim Director and has the following contact phone number (209) 525-6225.
The enumeration date for this NPI number is 5/29/2007 and was last updated on 10/11/2019.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 103T00000X | Psychologist | | | | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 5055 | MEDICAID | CALIFORNIA | |
