Provider Demographics
NPI:1720595812
Name:FINNEMAN, RIANNON
Entity Type:Individual
Prefix:
First Name:RIANNON
Middle Name:
Last Name:FINNEMAN
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 1:1133 W SACRAMENTO AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-4353
Mailing Address - Country:US
Mailing Address - Phone:209-581-2423
Mailing Address - Fax:
Practice Address - Street 1:287 RIO LINDO AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1973
Practice Address - Country:US
Practice Address - Phone:530-245-5805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician