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Contact Information

MINDY COSTELLO
4601 DALE RD
MODESTO, CA95356-9718
 Phone: 209-735-7591
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Care

2278G1100X
Indicates primary specialty

NPI Profile & details for MINDY COSTELLO · (Female)

NPI Number 1053877597
Status Active
Credentials
Entity Individual
Enumeration date 02/20/2019
Last updated 02/20/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 29664
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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