Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PHOENIX JETT-DIAS
Active Sole ProprietorPHOENIX JETT-DIAS is a Student (Health Education/Training) healthcare provider located in MODESTO, California. NPI 1114768280 is currently active in the NPPES registry. Verify at CMS.
Student (Health Education/Training) · MODESTO, CA
Registration Details
- NPI Number
- 1114768280
- Provider Type
- Individual
- Gender
- Unknown
- NPI Issued
- Jun 3, 2024 (2.1671183090608 yrs)
- Last Updated
- Jul 25, 2025
- Sole Proprietor
- Yes
Practice Information
- Address
-
3300 TULLY RDMODESTO, CA, 953500836Browse CA providers · Browse ZIP 95350
- Phone
- 2095850555
- Fax
- 2095965142
- Primary Specialty
-
Student (Health Education/Training)
390200000X
- Additional Specialty
- Peer Specialist
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Case Manager
Other Student (Health Education/Training) Providers in MODESTO, CA
| Name | Credential | NPI |
|---|---|---|
| ANDERS E GRANT | MD | 1093706244 |
| MS. SHELLY DENISE BOOKER | — | 1972677839 |
| BRENT HART | — | 1861524472 |
| JEREMY PANNELL II | — | 1376663328 |
| DIANA LYN BRASIL | — | 1629199609 |
| DARCY LEIGH VAUGHN | — | 1629190483 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.