Healthcare Provider Details

I. General information

NPI: 1972679421
Provider Name (Legal Business Name): MR. JOSEPH CHARLES DUDAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 COHASSET ROAD SUITE 25
CHICO CA
95926
US

IV. Provider business mailing address

PO 3277
CHICO CA
95927
US

V. Phone/Fax

Practice location:
  • Phone: 530-879-3841
  • Fax: 530-879-3842
Mailing address:
  • Phone: 530-899-7302
  • 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: