Healthcare Provider Details

I. General information

NPI: 1821164567
Provider Name (Legal Business Name): SHELLY LANEY SR BVRL HLTH CNSL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 COHASSET RD STE 165
CHICO CA
95926-2460
US

IV. Provider business mailing address

20 FREMONT ST #11
CHICO CA
95928
US

V. Phone/Fax

Practice location:
  • Phone: 530-879-3950
  • Fax:
Mailing address:
  • Phone: 530-809-1404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: