| NPI | 1871252569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMRA DAWN OLSON Authorized Official 530-242-4523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| 122300000X Dentist | |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2023-11-30 |