Provider Demographics
NPI:1477765949
Name:MAHONEY, NEDA (MD)
Entity Type:Individual
Prefix:
First Name:NEDA
Middle Name:
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1469 HUMBOLDT RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1469 HUMBOLDT RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-9116
Practice Address - Country:US
Practice Address - Phone:530-891-1917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77681207VH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMM70116GMedicaid
CACMM70370FMedicaid
CAZZR11629FMedicaid
CACMM70268FMedicaid