AILEEN LOGAN (NPI# 1962944033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962944033 |
| Entity Type | Individual |
| Full Name | AILEEN LOGAN |
| Credential | RADT-1 |
| Practice Address |
1100 Kansas Ave Ste B Modesto CA 95351-1596 |
| Mailing Address |
2970 Pecan Ave Merced CA 95340-2337 |
| Practice Telephone | 2095791151 |
| Practice Fax Number | 2095799605 |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2019-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DRUG AND ALCOHOL | 1962944033 | 01 |
| Street Address |
1100 KANSAS AVE STE B |
| City | MODESTO |
| State | CA |
| Zip Code | 95351-1596 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619004561 | Gayle Case | Case Manager/Care Coordinator | 1100 Kansas Ave Ste B, Modesto, CA 95351-1596 | 2007-02-27 |
| 1154951242 | Robin Lynn Cunningham | Counselor | 1100 Kansas Ave Ste B, Modesto, CA 95351-1596 | 2020-01-17 |
| 1881236024 | Tifany Lee Hamilton | Counselor | 1100 Kansas Ave Ste B, Modesto, CA 95351-1596 | 2019-10-09 |
| 1164988747 | Kara Lee Mobley | Counselor | 1100 Kansas Ave Ste B, Modesto, CA 95351-1596 | 2019-02-19 |
| 1679044879 | Melissa Ann Norvise | Counselor | 1100 Kansas Ave Ste B, Modesto, CA 95351-1596 | 2018-12-16 |
| 1366561912 | Katrina Lynn Stoughtenborough | Counselor | 1100 Kansas Ave Ste B, Modesto, CA 95351-1596 | 2007-03-28 |
| 1013049444 | Stanislaus County Behavioral Health & Recovery Services | Counselor | 1100 Kansas Ave Ste B, Modesto, CA 95351-1596 | 2007-03-12 |
| 1447387378 | Angie Prieto | Case Manager/Care Coordinator | 1100 Kansas Ave Ste B, Modesto, CA 95351-1596 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700392487 | Western Dental Services, Inc. | Dentist | 1524 Richland Ave, Ceres, CA 95351 | 2017-12-18 |
| 1881039873 | Sabrina Arora-thissen | Family Medicine | 401 Paradise Rd. Ste, Modesto, CA 95351 | 2013-05-03 |
| 1407163561 | Maliza Cahee Oliver | Dentist | 1404 Mitchell Rd, Modesto, CA 95351 | 2010-09-09 |
| 1124345616 | Jason Lee Paul Wayrynen | Social Worker | 1219 N Carpenter Rd Ste 12, Modesto, CA 95351 | 2010-04-23 |
| 1841469640 | Edgar Hse-hwa Han | Physical Medicine & Rehabilitation | 1521 N. Carpenter Road, Suite D-1, Modesto, CA 95351 | 2008-02-26 |
| 1326259326 | Karen Ann Peterson | Nurse Practitioner | 1340 Mitchell Rd, Modesto, CA 95351 | 2007-05-24 |
| 1013139054 | Bounchanh Trysavath | Physician Assistant | 300 I St, Modesto, CA 95351 | 2007-05-02 |
| 1245363464 | Sharon Basaldua1 | Counselor | 813 Moon Lane, Modesto, CA 95351 | 2007-03-14 |
| 1710046834 | Phil Chen | Dentist | 1460 Mitchell Road, Suite B, Modesto, CA 95351 | 2006-12-06 |
| 1649366055 | Victor Y. Chen | Family Medicine | 401 Paradise Road, Suite E, Modesto, CA 95351 | 2006-10-04 |
| Find all providers in zip 95351 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063055812 | Diana Harrison | Counselor | 1235 Mchenry Ave # A&b, Modesto, CA 95350-5370 | 2019-10-24 |
| 1710468095 | Dominic Maurice Casaca | Counselor | 616 Perfidia Ave, Modesto, CA 95351-4135 | 2018-08-24 |
| 1659867513 | Amalia Tapia | Counselor | 1235 Mchenry Ave Unit A&b, Modesto, CA 95350-5370 | 2018-07-03 |
| 1265934301 | Ben Hopp | Counselor | 123 Mchenry Ave, Modesto, CA 95354-0541 | 2018-03-05 |
| 1447772488 | Selenee Marie Flores | Counselor | 1235 Mchenry Ave # Ab, Modesto, CA 95350-5370 | 2017-07-12 |
| 1801325477 | Holly Elizabeth Moore | Counselor | 2000 W Briggsmore Ave Ste 1, Modesto, CA 95350-3839 | 2017-06-07 |
| 1942737507 | Gloria Edith Robles | Counselor | 3125 Mchenry Ave Ste D, Modesto, CA 95350-1451 | 2017-05-15 |
| 1184088668 | Michelle Lucas | Counselor | 1421 Mosswood Ln, Modesto, CA 95355-1555 | 2016-04-11 |
| 1407229248 | Roy Douglas | Counselor | 1235 Mcherney, A and B, Modesto, CA 95350-9411 | 2015-11-02 |
| 1639541394 | Dynese Lee Addotta | Counselor | 1520 Goldenwood Dr, Modesto, CA 95350-3865 | 2015-10-21 |
| Find all providers in MODESTO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.