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General NPI Number Information
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NPI Number | 1831563931
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Entity Type | Organization
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Legal Business Name | BUTTE COUNTY
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 11/30/2015
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Provider Practice Location Address
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Address Line | 1812 HARDIAL DR
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City | YUBA CITY
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State | CA
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Zip | 95993-9429
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Country | US
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Telephone | 530-301-7611
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Fax |
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Provider Business Mailing Address
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Address Line | 1812 HARDIAL DR
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City | YUBA CITY
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State | CA
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Zip | 95993-9429
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Country | US
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Telephone | 530-301-7611
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Fax |
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Authorized Official
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Title or Position | LVN/LPT
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Name | RAJWANT GILL
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Credential |
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Telephone | 530-301-7611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | VN241146
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License Number State | CA
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