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NPI Code Detail

MEDICARE: MR. JOHN THOMAS STAPP

MEDICARE: MR. JOHN THOMAS STAPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1023147147
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN THOMAS STAPP
Provider Business Mailing Address
First Line : 2400 WASHINGTON AVE
Second Line :
City : REDDING
State : CA
Zip : 96001-2832
Country : US
Telephone Number : 530-241-1663
Fax Number :
Provider Business Practice Location Address
First Line : 2400 WASHINGTON AVE
Second Line :
City : REDDING
State : CA
Zip : 96001-2832
Country : US
Telephone Number : 530-241-1663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 07/08/2007

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Directions to “ MR. JOHN THOMAS STAPP ” Practice Location

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