Provider Demographics
NPI:1770756736
Name:FREMONT-RIDEOUT HEALTH GROUP
Entity type:Organization
Organization Name:FREMONT-RIDEOUT HEALTH GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP SENIOR SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-790-3000
Mailing Address - Street 1:840 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-2833
Mailing Address - Country:US
Mailing Address - Phone:530-790-3075
Mailing Address - Fax:530-790-3071
Practice Address - Street 1:840 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-2833
Practice Address - Country:US
Practice Address - Phone:530-790-3075
Practice Address - Fax:530-790-3071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)