Provider Demographics
NPI:1770679656
Name:FEATHER RIVER HOSPITAL
Entity Type:Organization
Organization Name:FEATHER RIVER HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:JUANITA
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD
Authorized Official - Phone:530-877-9361
Mailing Address - Street 1:5974 PENTZ ROAD
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969
Mailing Address - Country:US
Mailing Address - Phone:530-877-9361
Mailing Address - Fax:530-876-7943
Practice Address - Street 1:5974 PENTZ RD
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-5509
Practice Address - Country:US
Practice Address - Phone:530-877-9361
Practice Address - Fax:530-876-7943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA884510133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ266312Medicare ID - Type UnspecifiedREGISTERED DIETITIAN