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General NPI Number Information
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NPI Number | 1669478590
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Entity Type | Organization
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Legal Business Name | EASTERN PLUMAS HEALTH CARE DISTRICT
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Dates
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Enumeration Date | 06/24/2005
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 700 THIRD AVE
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City | LOYALTON
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State | CA
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Zip | 96118
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Country | US
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Telephone | 530-832-6500
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Fax | 530-832-1105
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Provider Business Mailing Address
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Address Line | 500 1ST AVE
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City | PORTOLA
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State | CA
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Zip | 96122-9406
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Country | US
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Telephone | 530-832-6500
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Fax | 530-832-1105
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Authorized Official
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Title or Position | CFO
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Name | MS. JERILEE NELSON
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Credential | CPA
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Telephone | 530-832-6578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 230000014
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 058597
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License Number State | CA
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