Healthcare Provider Details

I. General information

NPI: 1235914862
Provider Name (Legal Business Name): COUNTY OF GLENN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 E WALKER STREET
ORLAND CA
95963
US

IV. Provider business mailing address

PO BOX 611
WILLOWS CA
95988-0611
US

V. Phone/Fax

Practice location:
  • Phone: 530-865-1165
  • Fax:
Mailing address:
  • Phone:
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

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