Provider Demographics
NPI:1780088047
Name:CHICO CREEK COUNSELING FOR MARRIAGE AND FAMILY APC
Entity type:Organization
Organization Name:CHICO CREEK COUNSELING FOR MARRIAGE AND FAMILY APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-410-0505
Mailing Address - Street 1:1600 HUMBOLDT RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-8100
Mailing Address - Country:US
Mailing Address - Phone:530-410-0505
Mailing Address - Fax:530-487-8608
Practice Address - Street 1:1600 HUMBOLDT RD STE 3
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-8100
Practice Address - Country:US
Practice Address - Phone:530-410-0505
Practice Address - Fax:530-487-8608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT46406106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty