Healthcare Provider Details

I. General information

NPI: 1295566446
Provider Name (Legal Business Name): CHELSI ELAINE SAMPLEY RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 LINCOLN ST
OROVILLE CA
95966-5961
US

IV. Provider business mailing address

9743 GARNET CT
LIVE OAK CA
95953-9419
US

V. Phone/Fax

Practice location:
  • Phone: 530-534-7500
  • Fax:
Mailing address:
  • Phone: 530-933-1382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number23148
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: