Healthcare Provider Details

I. General information

NPI: 1760319016
Provider Name (Legal Business Name): PAVONE FAMILY THERAPY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1179 BELTLINE RD
REDDING CA
96003-1955
US

IV. Provider business mailing address

215 LAKE BLVD # 664
REDDING CA
96003-2506
US

V. Phone/Fax

Practice location:
  • Phone: 530-638-3559
  • Fax:
Mailing address:
  • Phone: 530-638-3559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DANIELLA C PAVONE
Title or Position: CEO
Credential: M.A., LMFT, LPCC
Phone: 530-638-3559