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General NPI Number Information
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NPI Number | 1780061366
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL HEALTH
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Dates
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Enumeration Date | 05/02/2015
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Last Update Date | 05/02/2015
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Provider Practice Location Address
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Address Line | 729 WILWICK WAY
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City | YUBA CITY
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State | CA
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Zip | 95991-3339
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Country | US
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Telephone | 530-755-4855
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Fax | 530-741-8509
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Provider Business Mailing Address
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Address Line | 820 1/2 C ST
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City | MARYSVILLE
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State | CA
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Zip | 95901-5374
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Country | US
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Telephone | 530-755-4855
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Fax | 530-741-8509
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Authorized Official
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Title or Position | CEO
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Name | LEELA FITZWATER
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Credential | LHPT
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Telephone | 530-218-2046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 65878
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License Number State | CA
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