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General NPI Number Information
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NPI Number | 1003377615
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Entity Type | Individual
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Provider Name | JARETT ROY BEAUDOIN MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2019
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 78 TABLE MOUNTAIN BLVD
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City | OROVILLE
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State | CA
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Zip | 95965-3578
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Country | US
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Telephone | 530-552-3918
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Fax |
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Provider Business Mailing Address
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Address Line | 202 MIRA LOMA DR
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City | OROVILLE
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State | CA
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Zip | 95965-3500
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Country | US
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Telephone | 530-552-3932
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Fax | 530-538-2165
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A191533
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | A191533
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License Number State | CA
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