Jimmy Dean Van Tassel in Modesto - Clinical
Jimmy Dean Van Tassel - NPI 1699831214
Jimmy Dean Van Tassel is a Clinical in Modesto, California. Jimmy Dean Van Tassel practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jimmy Dean Van Tassel is 1699831214. The last update date is 2007-07-08.
Jimmy Dean Van Tassel's current location address is 1320 Standiford Ave, Modesto, California. You can contact this provider via phone number 2095575765. The mailing address for Jimmy Dean Van Tassel is 1320 Standiford Ave, Modesto, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jimmy Dean Van Tassel |
|---|---|
| Address | 1320 Standiford Ave, Modesto, California |
| Phone Number | 2095575765 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1699831214 |
|---|---|
| Provider Enumeration Date | 2006-12-28 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1320 Standiford Ave |
|---|---|
| City | Modesto |
| State | California (CA) |
| Post Code | 953500726 |
| Phone Number | 2095575765 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCS 17803 |
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What is the unique 10-digit identifier code issued to Jimmy Dean Van Tassel by the Centers for Medicare & Medicaid Services?
The Jimmy Dean Van Tassel has been assigned the NPI (National Provider Identifier) 1699831214 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the Jimmy Dean Van Tassel's physical address?
The Jimmy Dean Van Tassel is physically located at 1320 Standiford Ave, in the city of Modesto, CA, with the postal code 953500726.
What is Jimmy Dean Van Tassel's area of expertise and its corresponding taxonomy classification?
The Jimmy Dean Van Tassel's field of specialization is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their areas of practice.
On what date did the Jimmy Dean Van Tassel receive its 1699831214 assignment from the Centers for Medicare & Medicaid Services?
The Jimmy Dean Van Tassel was assigned its 1699831214 by the Centers for Medicare & Medicaid Services on 2006-12-28.
When was the Jimmy Dean Van Tassel's information last updated?
The Jimmy Dean Van Tassel's information was last updated on 2007-07-08.