Healthcare Provider Details

I. General information

NPI: 1336070929
Provider Name (Legal Business Name): CALI PRIMARY MOBILE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 DELLWOOD DR
REDDING CA
96003-9318
US

IV. Provider business mailing address

1968 DELLWOOD DR
REDDING CA
96003-9318
US

V. Phone/Fax

Practice location:
  • Phone: 530-806-8964
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TRIET NGUYEN
Title or Position: OPERATOR
Credential: FNP
Phone: 530-806-8964