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NPI Code Detail

MEDICARE: DESIREE WAIDELICH

MEDICARE:   DESIREE  WAIDELICH
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
1225C00000XRehabilitation Counselor

General Provider Information

NPI Number : 1316545320
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESIREE WAIDELICH
Provider Business Mailing Address
First Line : PO BOX 3940
Second Line :
City : QUINCY
State : CA
Zip : 95971-3940
Country : US
Telephone Number : 530-283-3330
Fax Number :
Provider Business Practice Location Address
First Line : 630 BETTY BELLE LN
Second Line :
City : CHICO
State : CA
Zip : 95973-8702
Country : US
Telephone Number : 530-283-3330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2020
Last Update Date : 06/28/2024

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Directions to “ DESIREE WAIDELICH ” Practice Location

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