Healthcare Provider Details

I. General information

NPI: 1528130259
Provider Name (Legal Business Name): SALLY MITCHELL-COX CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 SISTER MARY COLUMBA DR
RED BLUFF CA
96080-4356
US

IV. Provider business mailing address

3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 530-528-6170
  • Fax: 530-528-6192
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNP3155
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberRN336606
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: