Provider Demographics
NPI:1366632366
Name:ASPIRANET BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ASPIRANET BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-866-4080
Mailing Address - Street 1:1620 CUMMINS DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95358-6400
Mailing Address - Country:US
Mailing Address - Phone:209-576-1750
Mailing Address - Fax:208-576-1768
Practice Address - Street 1:1620 CUMMINS DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95358-6400
Practice Address - Country:US
Practice Address - Phone:209-576-1750
Practice Address - Fax:208-576-1768
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPIRANET
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-26
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA415200481251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health