Provider Demographics
NPI:1336881390
Name:PEACOCK, ANNIKA
Entity Type:Individual
Prefix:
First Name:ANNIKA
Middle Name:
Last Name:PEACOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNIKA
Other - Middle Name:
Other - Last Name:SCHAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 COUNTY HOSPITAL RD #109
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971
Mailing Address - Country:US
Mailing Address - Phone:530-283-6307
Mailing Address - Fax:
Practice Address - Street 1:372 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:CA
Practice Address - Zip Code:96020
Practice Address - Country:US
Practice Address - Phone:530-283-6307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator