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General NPI Number Information
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NPI Number | 1619762861
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Entity Type | Individual
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Provider Name | SELENA MARIE HALE
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Gender | Female
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 560 COHASSET RD STE 185
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City | CHICO
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State | CA
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Zip | 95926-2460
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Country | US
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Telephone | 530-552-5058
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3298
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City | CLEARLAKE
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State | CA
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Zip | 95422-3298
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Country | US
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Telephone |
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | CA
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