Healthcare Provider Details

I. General information

NPI: 1659501492
Provider Name (Legal Business Name): CHESTON STEARNS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 04/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3191 CHURN CREEK RD
REDDING CA
96002-2123
US

IV. Provider business mailing address

20397 RIVER VALLEY DR
ANDERSON CA
96007-8409
US

V. Phone/Fax

Practice location:
  • Phone: 530-224-7160
  • Fax:
Mailing address:
  • Phone: 530-828-8340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: