Provider Demographics
NPI:1922146984
Name:NORTH VALLEY NEUROLOGICAL ASSOCIATES INC.
Entity Type:Organization
Organization Name:NORTH VALLEY NEUROLOGICAL ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-751-9604
Mailing Address - Street 1:1215 PLUMAS ST
Mailing Address - Street 2:SUITE 1300A
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3455
Mailing Address - Country:US
Mailing Address - Phone:530-751-9604
Mailing Address - Fax:530-751-9531
Practice Address - Street 1:1215 PLUMAS ST
Practice Address - Street 2:SUITE 1300A
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3455
Practice Address - Country:US
Practice Address - Phone:530-751-9604
Practice Address - Fax:530-751-9531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6649502084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G649500Medicaid
CAY 04601Medicare UPIN