Healthcare Provider Details

I. General information

NPI: 1689922023
Provider Name (Legal Business Name): MS. NANCY M. LAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 BIRD ST
OROVILLE CA
95965-4908
US

IV. Provider business mailing address

2430 BIRD ST
OROVILLE CA
95965-4908
US

V. Phone/Fax

Practice location:
  • Phone: 530-538-7277
  • Fax:
Mailing address:
  • Phone: 530-538-7277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: