Healthcare Provider Details

I. General information

NPI: 1598861635
Provider Name (Legal Business Name): DOROTHY I CHINNOCK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 12/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 COHASSET RD
CHICO CA
95926-2242
US

IV. Provider business mailing address

5373 BREEZEWOOD DR
PARADISE CA
95969-5571
US

V. Phone/Fax

Practice location:
  • Phone: 530-781-1440
  • Fax: 530-893-6864
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP3500
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: