Provider Demographics
NPI:1700986908
Name:DIGGS, STEPHEN M (PSY)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:DIGGS
Suffix:
Gender:M
Credentials:PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8959
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-8959
Mailing Address - Country:US
Mailing Address - Phone:530-891-4400
Mailing Address - Fax:530-636-4772
Practice Address - Street 1:572 RIO LINDO AVE STE 203
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1851
Practice Address - Country:US
Practice Address - Phone:530-891-4400
Practice Address - Fax:530-636-4772
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18239103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY182390Medicaid
CAQ03774Medicare UPIN
CAPSY182390Medicaid