Provider Demographics
NPI:1437775202
Name:NORTHERN VALLEY INDIAN HEALTH
Entity Type:Organization
Organization Name:NORTHERN VALLEY INDIAN HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-934-9293
Mailing Address - Street 1:207 N BUTTE ST
Mailing Address - Street 2:
Mailing Address - City:WILLOWS
Mailing Address - State:CA
Mailing Address - Zip Code:95988-2803
Mailing Address - Country:US
Mailing Address - Phone:530-330-8800
Mailing Address - Fax:530-934-3285
Practice Address - Street 1:1280 E GIBSON RD
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95776-6315
Practice Address - Country:US
Practice Address - Phone:530-207-5499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN VALLEY INDIAN HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center