Provider Demographics
NPI:1558256271
Name:AVALOS, AUTUMN FAITH (RN)
Entity type:Individual
Prefix:MRS
First Name:AUTUMN
Middle Name:FAITH
Last Name:AVALOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:AUTUMN
Other - Middle Name:FAITH
Other - Last Name:HEDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:170 ARTESIA DR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-5614
Mailing Address - Country:US
Mailing Address - Phone:530-354-4627
Mailing Address - Fax:
Practice Address - Street 1:1531 ESPLANADE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3310
Practice Address - Country:US
Practice Address - Phone:530-332-7309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95167088163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine