MEDICARE: MS. JANUARY REGINA GILES ACSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	99887	CA

General Provider Information

NPI Number	:	1215521281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANUARY REGINA GILES ACSW

Provider Business Mailing Address
First Line	:	PO BOX 6116
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95966-1116
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1870 BIRD ST
Second Line	:
City	:	OROVILLE
State	:	CA
Zip	:	95965-4855
Country	:	US
Telephone Number	:	530-680-7321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2021
Last Update Date	:	02/21/2021

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