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General NPI Number Information
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NPI Number | 1881613669
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Entity Type | Organization
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Legal Business Name | AMPLA HEALTH
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 285 COHASSET RD
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City | CHICO
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State | CA
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Zip | 95926-5513
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Country | US
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Telephone | 530-342-6065
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX AD
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City | YUBA CITY
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State | CA
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Zip | 95992-1396
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Country | US
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Telephone | 530-751-3778
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Fax | 530-751-1237
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Authorized Official
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Title or Position | BILLING ACCOUNT MANAGER
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Name | VICKI L CHISSIE
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Credential |
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Telephone | 530-751-3778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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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 | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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