Provider Demographics
NPI:1902061625
Name:MACHADO, GINA M (MSW)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:MACHADO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CLAUS RD
Mailing Address - Street 2:BUILDING A
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-9711
Mailing Address - Country:US
Mailing Address - Phone:209-557-6300
Mailing Address - Fax:209-557-6386
Practice Address - Street 1:1501 CLAUS RD
Practice Address - Street 2:BUILDING A
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-9711
Practice Address - Country:US
Practice Address - Phone:209-557-6300
Practice Address - Fax:209-557-6386
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical