Provider Demographics
NPI:1285162198
Name:GIVANS, PAMELA DIANE
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:DIANE
Last Name:GIVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95992-1510
Mailing Address - Country:US
Mailing Address - Phone:530-822-7327
Mailing Address - Fax:
Practice Address - Street 1:446 2ND ST
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-5525
Practice Address - Country:US
Practice Address - Phone:530-822-7327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator