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General NPI Number Information
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NPI Number | 1154956910
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Entity Type | Individual
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Provider Name | PAIGE MCCALL HEWITT RADT-I
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Gender | Female
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Dates
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Enumeration Date | 03/11/2020
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 8086 ORANGE AVE
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City | FAIR OAKS
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State | CA
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Zip | 95628-5941
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Country | US
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Telephone | 916-410-6912
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Fax |
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Provider Business Mailing Address
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Address Line | 20271 SW BIRCH ST
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1752
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Country | US
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Telephone | 916-916-4106
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R1378450220
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License Number State | CA
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