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CRESTWOOD MANOR - FREMONT
NPI 1083747505
Community/Behavioral Health in Fremont, CA

Active since March 13, 2007CLIA Certified · 4 labs
2171 MOWRY AVE, FREMONT, CA 94538(209) 525-7423 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Crestwood Manor - Fremont NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRESTWOOD MANOR - FREMONT (NPI 1083747505) is a healthcare organization registered as a community/behavioral health in Fremont, California and active in the NPI registry since March 2007. The organization holds 4 active CLIA laboratory certificates and lists Denise C Hunt, Behavioral Health Director, as its authorized official.

NPPES Registry Identity

NPI1083747505
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameSTANISLAUS COUNTY
Location Address2171 MOWRY AVEFremont, CA 94538-1717
Mailing Address800 Scenic DrModesto, CA 95350-6131 · (209) 525-7423
Phone(209) 525-7423
Organization SubpartNo
Authorized OfficialDenise C HuntBehavioral Health Director · (209) 525-6225
Enumeration DateMarch 13, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1083747505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
2171 MOWRY AVE, Fremont, CA 94538
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Other Names 1

Other NameCrestwood Manor - Fremont

Other Identifiers 1

Medicaid50AJCA

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0967966

Crestwood Manor · Fremont, CA
Active · expires Nov 28, 2027
CLIA Number05D0967966
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateNovember 29, 2025
Certificate Expiration DateNovember 28, 2027
Laboratory DirectorDr. Rabin Khetrapal
Laboratory Phone(510) 651-1244
Laboratory LocationCrestwood Manor4303 Stevenson Blvd, Fremont, CA 94538
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0904425

Stanislaus County Health Services Agency- Mc Henry Medical Office · Modesto, CA
Active · expires Aug 16, 2027
CLIA Number05D0904425
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateAugust 17, 2025
Certificate Expiration DateAugust 16, 2027
Laboratory DirectorKenneth James
Laboratory Phone(209) 558-5312
Laboratory LocationStanislaus County Health Services Agency- Mc Henry Medical Office1209 Woodrow Ave, Ste B-10, Modesto, CA 95350
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 05D1014361

Stanislaus County Public Health Stanislaus County Health Svcs Agency Oa C&t Prgm · Modesto, CA
Active · expires Jul 1, 2027
CLIA Number05D1014361
Laboratory TypePh Clinic
Certificate Effective DateJuly 2, 2025
Certificate Expiration DateJuly 1, 2027
Laboratory DirectorTheognosia Papasozomenos
Laboratory Phone(209) 558-8804
Laboratory LocationStanislaus County Public Health Stanislaus County Health Svcs Agency Oa C&t Prgm1524 Mchenry Ave Ste 300, Modesto, CA 95350
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D1009062

Stanislaus County Health Services Agency Pediatric Ctr · Modesto, CA
Active · expires Feb 4, 2027
CLIA Number05D1009062
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateFebruary 5, 2025
Certificate Expiration DateFebruary 4, 2027
Laboratory DirectorJoy Farley
Laboratory Phone(209) 558-8400
Laboratory LocationStanislaus County Health Services Agency Pediatric Ctr830 Scenic Dr, Ste A, Modesto, CA 95350
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CRESTWOOD BEHAVIORAL HEALTH, INC.
Skilled Nursing Facility
2171 MOWRY AVE
FREMONT, CA 94538
Alameda County (510) 793-8383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stanislaus County's NPI number?

The NPI number for Stanislaus County is 1083747505. It was assigned to this organization in the NPPES registry on March 13, 2007. The provider is also known as Crestwood Manor - Fremont.

Where is Stanislaus County located?

Stanislaus County is located at 2171 Mowry Ave, Fremont, CA 94538. The listed phone number is (209) 525-7423.

What is Stanislaus County's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Does Stanislaus County hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Stanislaus County was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.