Healthcare Provider Details

I. General information

NPI: 1073715728
Provider Name (Legal Business Name): JUANITA L BAUGUESS LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

592 RIO LINDO AVE
CHICO CA
95926-1817
US

IV. Provider business mailing address

109 PARMAC RD STE 1
CHICO CA
95926-2218
US

V. Phone/Fax

Practice location:
  • Phone: 530-891-2775
  • Fax:
Mailing address:
  • Phone: 530-891-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number195149
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: