Provider Demographics
NPI:1922090489
Name:FEATHER RIVER TRIBAL HEALTH, INC.
Entity Type:Organization
Organization Name:FEATHER RIVER TRIBAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNZEKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-534-3793
Mailing Address - Street 1:2145 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-5870
Mailing Address - Country:US
Mailing Address - Phone:530-534-3793
Mailing Address - Fax:530-534-3820
Practice Address - Street 1:555 W ONSTOTT RD
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993
Practice Address - Country:US
Practice Address - Phone:530-751-8454
Practice Address - Fax:530-751-8456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-19
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2300000265261QC1500X
261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABCP70683FOtherBREAST CANCER PROGRAM
CATHP70683FMedicaid
CA051972Medicare ID - Type UnspecifiedYUBA CITY FACILITY