Provider Demographics
NPI:1154553741
Name:NURSES & PROFESSIONAL HEALTHCARE
Entity type:Organization
Organization Name:NURSES & PROFESSIONAL HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:STAFF NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:JENE
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:530-519-1251
Mailing Address - Street 1:2639 FOREST AVE
Mailing Address - Street 2:SUTIE 110
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-4393
Mailing Address - Country:US
Mailing Address - Phone:530-899-2255
Mailing Address - Fax:530-899-2260
Practice Address - Street 1:2639 FOREST AVE
Practice Address - Street 2:SUTIE 110
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-4393
Practice Address - Country:US
Practice Address - Phone:530-899-2255
Practice Address - Fax:530-899-2260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN46854310500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness