Healthcare Provider Details

I. General information

NPI: 1417152448
Provider Name (Legal Business Name): MR. JEFFREY ATKISSON LESTER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 SKYWAY
PARADISE CA
95969-3280
US

IV. Provider business mailing address

1871 SKYWAY
CHICO CA
95928-8833
US

V. Phone/Fax

Practice location:
  • Phone: 530-872-2103
  • Fax: 530-872-7784
Mailing address:
  • Phone: 530-519-1689
  • Fax: 530-872-7784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: