Provider Demographics
NPI:1114415759
Name:NORTHSTATE FOOT & ANKLE SPECIALIST INC
Entity Type:Organization
Organization Name:NORTHSTATE FOOT & ANKLE SPECIALIST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:JUHL-DARLINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-891-3338
Mailing Address - Street 1:1806 FOUNDATION LN
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9206
Mailing Address - Country:US
Mailing Address - Phone:530-891-3338
Mailing Address - Fax:530-894-5771
Practice Address - Street 1:1806 FOUNDATION LANE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928
Practice Address - Country:US
Practice Address - Phone:530-895-3668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-30
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4327261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric