Healthcare Provider Details

I. General information

NPI: 1033817572
Provider Name (Legal Business Name): CHILDREN'S HOPE FOSTER FAMILY AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 VIRGINIA ST
GRIDLEY CA
95948-2133
US

IV. Provider business mailing address

567 VIRGINIA ST
GRIDLEY CA
95948-2133
US

V. Phone/Fax

Practice location:
  • Phone: 530-846-4955
  • Fax:
Mailing address:
  • Phone: 530-846-4955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN PAYNE
Title or Position: CEO
Credential: LCSW
Phone: 530-846-4955