Provider Demographics
NPI:1154815033
Name:BUTTE PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:BUTTE PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:530-342-2952
Mailing Address - Street 1:1430 EAST AVE STE 2B
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1629
Mailing Address - Country:US
Mailing Address - Phone:530-342-2952
Mailing Address - Fax:530-487-8129
Practice Address - Street 1:1430 EAST AVE STE 2B
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1629
Practice Address - Country:US
Practice Address - Phone:530-342-2952
Practice Address - Fax:530-487-8129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health