Provider Demographics
NPI:1043854730
Name:OATES, MARLA DAWN
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:DAWN
Last Name:OATES
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 1:260 COHASSET RD STE 120
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2282
Mailing Address - Country:US
Mailing Address - Phone:530-894-5933
Mailing Address - Fax:530-894-5791
Practice Address - Street 1:260 COHASSET RD STE 120
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2282
Practice Address - Country:US
Practice Address - Phone:530-894-5933
Practice Address - Fax:530-894-5791
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110718104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker