Phoenix Jett-dias
Phoenix Jett-dias is a provider specialising in Student in an Organized Health Care Education/Training Program in Modesto, CA, registered under NPI 1114768280. This provider registers 4 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 3300 TULLY RD, Modesto, CA 95350. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Student in an Organized Health Care Education/Training Program covers
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. NUCC Health Care Provider Taxonomy, code 390200000X
All registered taxonomy codes
This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — | primary |
| 174400000X | Specialist | — | — | |
| 175T00000X | Peer Specialist | — | — | |
| 171M00000X | Case Manager/Care Coordinator | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1114768280 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jun 3, 2024 |
| Last updated | Jul 25, 2025 |
| Status | Active |
| Sole proprietor | Yes |
| Practice address |
3300 TULLY RD Modesto, CA 95350 (209) 585-0555 Fax (209) 596-5142 |
| Mailing address |
3300 TULLY RD STE B6 Modesto, CA 95350 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 1 | 4 | 7 | 6 | 8 | 2 | 8 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 2 | 4 | 5 | 6 | 7 | 2 | 7 |
Sum = 60 · next multiple of 10 = 60 · check digit = 0 · actual last digit = 0
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.