MEDICARE: BUTTE COUNTY

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	251S00000X	Community/Behavioral Health Agency	VN241146	CA

General Provider Information

NPI Number	:	1831563931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUTTE COUNTY

Provider Business Mailing Address
First Line	:	1812 HARDIAL DR
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95993-9429
Country	:	US
Telephone Number	:	530-301-7611
Fax Number	:

Provider Business Practice Location Address
First Line	:	1812 HARDIAL DR
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95993-9429
Country	:	US
Telephone Number	:	530-301-7611
Fax Number	:

Authorized Official
Title or Position	:	LVN/LPT
Name	:	RAJWANT GILL
Credential	:
Telephone Number	:	530-301-7611

Provider Enumeration Date	:	11/30/2015
Last Update Date	:	11/30/2015

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Directions to “BUTTE COUNTY ” Practice Location

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