Healthcare Provider Details

I. General information

NPI: 1962389304
Provider Name (Legal Business Name): CHAD BUELL PPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/18/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 S JACKSON ST
RED BLUFF CA
96080-4505
US

IV. Provider business mailing address

3295 LAWRENCE RD
REDDING CA
96002-5051
US

V. Phone/Fax

Practice location:
  • Phone: 530-527-7840
  • Fax:
Mailing address:
  • Phone: 301-399-8581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberR511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: