Healthcare Provider Details

I. General information

NPI: 1245398676
Provider Name (Legal Business Name): COUNTY OF BUTTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

592 RIO LINDO AVENUE
CHICO CA
95926
US

IV. Provider business mailing address

3217 COHASSET RD
CHICO CA
95973-5404
US

V. Phone/Fax

Practice location:
  • Phone: 530-891-2775
  • Fax: 530-895-6547
Mailing address:
  • Phone: 530-891-2980
  • Fax: 530-895-6548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number1016001
License Number StateCA

VIII. Authorized Official

Name: SCOTT KENNELLY
Title or Position: DIRECTOR
Credential:
Phone: 530-891-2850