Healthcare Provider Details

I. General information

NPI: 1952810707
Provider Name (Legal Business Name): ERICA MARIE CHAVEZ FLETCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 09/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 COUNTY HOSPITAL RD STE 109
QUINCY CA
95971-9173
US

IV. Provider business mailing address

270 COUNTY HOSPITAL RD STE 109
QUINCY CA
95971-9173
US

V. Phone/Fax

Practice location:
  • Phone: 530-283-6307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: