Healthcare Provider Details

I. General information

NPI: 1861928293
Provider Name (Legal Business Name): BUTTE COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 05/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3536 BUTTE CAMPUS DR
OROVILLE CA
95965-8303
US

IV. Provider business mailing address

3536 BUTTE CAMPUS DR STUDENT HEALTH CLINIC
OROVILLE CA
95965-8303
US

V. Phone/Fax

Practice location:
  • Phone: 530-895-2441
  • Fax:
Mailing address:
  • Phone: 530-895-2441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDREW SULESKI
Title or Position: VICE PRESIDENT FOR ADMINISTRATION
Credential:
Phone: 530-895-2353