Provider Demographics
NPI:1558536268
Name:COLUSA COUNTY HEALTH & HUMAN SERVICES
Entity Type:Organization
Organization Name:COLUSA COUNTY HEALTH & HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT CLERK III
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-458-0275
Mailing Address - Street 1:124 E WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932-2950
Mailing Address - Country:US
Mailing Address - Phone:530-458-0275
Mailing Address - Fax:530-458-0204
Practice Address - Street 1:124 E WEBSTER ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2950
Practice Address - Country:US
Practice Address - Phone:530-458-0275
Practice Address - Fax:530-458-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZR11819FMedicaid
CAZZR11819FMedicaid