Healthcare Provider Details

I. General information

NPI: 1033761663
Provider Name (Legal Business Name): ROCHELLE HUGABOOM SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2019
Last Update Date: 07/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1246 BASSWOOD CT
CHICO CA
95926-2187
US

IV. Provider business mailing address

702 MANGROVE AVE. PMB 219
CHICO CA
95926
US

V. Phone/Fax

Practice location:
  • Phone: 530-332-8055
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP16791
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: