Provider Demographics
NPI:1669142626
Name:BIGELOW, CHANNEL PATRICE
Entity type:Individual
Prefix:
First Name:CHANNEL
Middle Name:PATRICE
Last Name:BIGELOW
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 1:1095 HILLTOP DR # 210
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-3811
Mailing Address - Country:US
Mailing Address - Phone:949-903-3866
Mailing Address - Fax:
Practice Address - Street 1:3179 BECHELLI LN STE 206
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2041
Practice Address - Country:US
Practice Address - Phone:530-336-7346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist