Provider Demographics
NPI:1568657724
Name:SISSON, EDWARD F (CPO)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:F
Last Name:SISSON
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 RIO LINDO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-5523
Mailing Address - Country:US
Mailing Address - Phone:530-894-6400
Mailing Address - Fax:530-894-6401
Practice Address - Street 1:165 RIO LINDO AVE STE 100
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-5523
Practice Address - Country:US
Practice Address - Phone:530-894-6400
Practice Address - Fax:530-894-6401
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist