Provider Demographics
NPI:1780061366
Name:OCCUPATIONAL HEALTH
Entity type:Organization
Organization Name:OCCUPATIONAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEELA
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZWATER
Authorized Official - Suffix:
Authorized Official - Credentials:LHPT
Authorized Official - Phone:530-218-2046
Mailing Address - Street 1:820 1/2 C ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-5374
Mailing Address - Country:US
Mailing Address - Phone:530-755-4855
Mailing Address - Fax:530-741-8509
Practice Address - Street 1:729 WILWICK WAY
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3339
Practice Address - Country:US
Practice Address - Phone:530-755-4855
Practice Address - Fax:530-741-8509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-02
Last Update Date:2015-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65878302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization