Healthcare Provider Details

I. General information

NPI: 1770859084
Provider Name (Legal Business Name): NORTHERN VALLEY INDIAN HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 SPRINGFIELD DR STE 175
CHICO CA
95928
US

IV. Provider business mailing address

207 N BUTTE ST
WILLOWS CA
95988-2803
US

V. Phone/Fax

Practice location:
  • Phone: 530-781-1440
  • Fax: 530-342-1663
Mailing address:
  • Phone: 530-934-9293
  • Fax: 530-934-2204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THERESA A CAMERON
Title or Position: ACCOUNT SERVICES MANAGER
Credential:
Phone: 530-330-8800