Healthcare Provider Details

I. General information

NPI: 1194594002
Provider Name (Legal Business Name): COMMUNITY ACTION AGENCY OF BUTTE COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 5TH AVE
OROVILLE CA
95965-5867
US

IV. Provider business mailing address

PO BOX 6369
CHICO CA
95927-6369
US

V. Phone/Fax

Practice location:
  • Phone: 530-712-2600
  • Fax:
Mailing address:
  • Phone: 530-712-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY HAWKINS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 530-712-2888