Provider Demographics
NPI:1639697097
Name:RHOADES, AMY LEE
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LEE
Last Name:RHOADES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3096
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-3096
Mailing Address - Country:US
Mailing Address - Phone:530-521-0799
Mailing Address - Fax:
Practice Address - Street 1:109 PARMAC RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2294
Practice Address - Country:US
Practice Address - Phone:530-891-2945
Practice Address - Fax:530-894-5791
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1111671041C0700X
CAASW90899104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical