=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871519603
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JESSICA M CHABOT M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 239 W COURT ST
-----------------------------------------------------
City | WOODLAND
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95695-2900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-668-2656
-----------------------------------------------------
Fax | 530-662-4527
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 216 F ST SUITE 153
-----------------------------------------------------
City | DAVIS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95616-4515
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 650-279-3250
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number | G60482
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | G60482
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------