Provider Demographics
NPI:1023462181
Name:RADINO, GENE RICHARD
Entity type:Individual
Prefix:
First Name:GENE
Middle Name:RICHARD
Last Name:RADINO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NEW HOPE
Other - Middle Name:
Other - Last Name:RECOVERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:220 STANDIFORD AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1159
Mailing Address - Country:US
Mailing Address - Phone:209-579-5628
Mailing Address - Fax:209-579-5637
Practice Address - Street 1:823 E ORANGEBURG AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4619
Practice Address - Country:US
Practice Address - Phone:209-527-9797
Practice Address - Fax:209-527-2007
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)