Healthcare Provider Details

I. General information

NPI: 1639548357
Provider Name (Legal Business Name): MR. JOHN WILLIAM COADY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 COHASSET RD STE 140
CHICO CA
95926-2478
US

IV. Provider business mailing address

100 RISA WAY APT 202
CHICO CA
95973-5018
US

V. Phone/Fax

Practice location:
  • Phone: 530-552-4936
  • Fax:
Mailing address:
  • Phone: 530-521-4457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: