Healthcare Provider Details

I. General information

NPI: 1356254486
Provider Name (Legal Business Name): DELTA HAWK FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 WEST ST
ANDERSON CA
96007-4254
US

IV. Provider business mailing address

2700 WEST ST
ANDERSON CA
96007-4254
US

V. Phone/Fax

Practice location:
  • Phone: 530-209-7767
  • Fax:
Mailing address:
  • Phone: 530-209-7767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAMES DEANE HUTTON
Title or Position: CEO
Credential:
Phone: 530-646-6777