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General NPI Number Information
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NPI Number | 1982549416
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Entity Type | Organization
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Legal Business Name | NORTHERN CALIFORNIA PSYCHOLOGY INC
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Dates
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Enumeration Date | 04/21/2026
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 630 SALEM ST STE 210
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City | CHICO
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State | CA
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Zip | 95928-5556
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Country | US
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Telephone | 530-588-9228
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Fax |
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Provider Business Mailing Address
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Address Line | 702 MANGROVE AVE STE 277
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City | CHICO
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State | CA
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Zip | 95926-3948
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Country | US
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Telephone | 530-588-9228
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. RUSTY GILMORE
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Credential | PHD
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Telephone | 530-588-9228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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