Healthcare Provider Details

I. General information

NPI: 1558858308
Provider Name (Legal Business Name): HEATHER SHALENE HUTCHISON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 BECHELLI LN STE A
REDDING CA
96002-2453
US

IV. Provider business mailing address

3609 BECHELLI LN STE A
REDDING CA
96002-2453
US

V. Phone/Fax

Practice location:
  • Phone: 530-242-2020
  • Fax: 530-241-2121
Mailing address:
  • Phone: 530-242-2020
  • Fax: 530-241-2121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: