Healthcare Provider Details

I. General information

NPI: 1851947659
Provider Name (Legal Business Name): MS. JILLIAN PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3191 CHURN CREEK RD
REDDING CA
96002-2123
US

IV. Provider business mailing address

PO BOX 494100
REDDING CA
96049-4100
US

V. Phone/Fax

Practice location:
  • Phone: 530-224-7160
  • Fax: 530-224-7168
Mailing address:
  • Phone: 530-224-7160
  • Fax: 530-224-7168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: