Healthcare Provider Details

I. General information

NPI: 1194484998
Provider Name (Legal Business Name): COUNTY OF GLENN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2021
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 YOLO ST
ORLAND CA
95963-1724
US

IV. Provider business mailing address

345 YOLO ST
ORLAND CA
95963-1724
US

V. Phone/Fax

Practice location:
  • Phone: 530-865-6165
  • Fax: 530-865-1001
Mailing address:
  • Phone: 530-934-1496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. BRENDA ENRIQUEZ
Title or Position: SR. COMMUNITY ACTION MANAGER
Credential:
Phone: 530-934-1496