Healthcare Provider Details

I. General information

NPI: 1295565448
Provider Name (Legal Business Name): SPOTLIGHT HOPE PROJECT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 MOJAVE CT
CHICO CA
95973-0307
US

IV. Provider business mailing address

460 MOJAVE CT
CHICO CA
95973-0307
US

V. Phone/Fax

Practice location:
  • Phone: 530-321-9677
  • Fax:
Mailing address:
  • Phone: 530-321-9677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: YOSELINE A LOPEZ MEJIA
Title or Position: CHW
Credential:
Phone: 530-321-9677