Healthcare Provider Details

I. General information

NPI: 1992632822
Provider Name (Legal Business Name): HEATHER E FOX RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

315 S OREGON ST
YREKA CA
96097-2949
US

IV. Provider business mailing address

6541 BIG SPRINGS RD
MONTAGUE CA
96064-9105
US

V. Phone/Fax

Practice location:
  • Phone: 530-842-8104
  • Fax: 530-842-0129
Mailing address:
  • Phone: 530-842-8104
  • Fax: 530-842-0129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number767390
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: