Healthcare Provider Details

I. General information

NPI: 1356424295
Provider Name (Legal Business Name): CONNIE SUE WEBBER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS CONNIE SUE WHITWORTH

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 WALNUT ST SUITE A
RED BLUFF CA
96080-3611
US

IV. Provider business mailing address

4804 RHONDA RD
ANDERSON CA
96007-9006
US

V. Phone/Fax

Practice location:
  • Phone: 530-527-5631
  • Fax: 530-527-0232
Mailing address:
  • Phone: 530-365-1489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License NumberRN431307
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN431307
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License NumberRN431307
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: