Healthcare Provider Details

I. General information

NPI: 1841439429
Provider Name (Legal Business Name): REIDUN LYNNE WADDELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REIDUN LYNNE GILBERT

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 COHASSET RD STE 100
CHICO CA
95926-2490
US

IV. Provider business mailing address

560 COHASSET RD STE 100
CHICO CA
95926-2490
US

V. Phone/Fax

Practice location:
  • Phone: 530-891-2999
  • Fax:
Mailing address:
  • Phone: 530-321-2379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number87080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: