Healthcare Provider Details

I. General information

NPI: 1104248715
Provider Name (Legal Business Name): BABETTE MAISS CMT,CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2014
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 WILLIAMSBURG LN
CHICO CA
95926-2225
US

IV. Provider business mailing address

4280 GREEN MEADOW LN
CHICO CA
95973-9231
US

V. Phone/Fax

Practice location:
  • Phone: 530-321-5668
  • Fax:
Mailing address:
  • Phone: 530-321-5668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number31518
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License NumberC70689
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: