Provider Demographics
NPI:1457489924
Name:BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH, OROVILLE MTU
Entity Type:Organization
Organization Name:BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH, OROVILLE MTU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANKENSHIP
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:530-552-3877
Mailing Address - Street 1:202 MIRA LOMA DR
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-3500
Mailing Address - Country:US
Mailing Address - Phone:530-538-7583
Mailing Address - Fax:530-538-2164
Practice Address - Street 1:2900 WYANDOTTE AVE
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6539
Practice Address - Country:US
Practice Address - Phone:530-532-5696
Practice Address - Fax:530-538-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACCS00129FMedicaid