Healthcare Provider Details

I. General information

NPI: 1447060066
Provider Name (Legal Business Name): GLENN COUNTY OFFICE OF EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 01/08/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 WALKER STREET
ORLAND CA
95963-1349
US

IV. Provider business mailing address

311 S. VILLA AVE.
WILLOWS CA
95988-2959
US

V. Phone/Fax

Practice location:
  • Phone: 530-934-6575
  • Fax:
Mailing address:
  • Phone: 530-934-6575
  • Fax: 530-934-6575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. T.J. GRUNDY
Title or Position: AT RISK YOUTH PROGRAM COORDINATOR
Credential:
Phone: 530-934-6575