Healthcare Provider Details

I. General information

NPI: 1609008671
Provider Name (Legal Business Name): TAO XIONG-THAO ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2009
Last Update Date: 08/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

865 MITCHELL AVE
OROVILLE CA
95965-4646
US

IV. Provider business mailing address

12 CAMERON DR
OROVILLE CA
95965-3581
US

V. Phone/Fax

Practice location:
  • Phone: 530-538-7950
  • Fax:
Mailing address:
  • Phone: 530-534-7245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number23837
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: