Healthcare Provider Details

I. General information

NPI: 1124320122
Provider Name (Legal Business Name): MARGARET POYTRESS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 01/08/2024
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 EXECUTIVE WAY STE 125
REDDING CA
96002-0634
US

IV. Provider business mailing address

P.O. BOX 491424
REDDING CA
96049
US

V. Phone/Fax

Practice location:
  • Phone: 530-276-8707
  • Fax:
Mailing address:
  • Phone: 530-276-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number76687
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number135623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: