| NPI | 1891710638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY BRANDON THORNOCK CEO 530-246-5074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207RR0500X Internal Medicine Rheumatology (Licence: CA 230000171) |
| 207V00000X Obstetrics & Gynecology (Licence: CA 230000171) | |
| 208000000X Pediatrics (Licence: CA 230000171) | |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: CA 230000171) | |
| 2085U0001X Radiology Diagnostic Ultrasound (Licence: CA 230000171) | |
| 363AM0700X Physician Assistant Medical (Licence: CA 230000171) | |
| 103G00000X Clinical Neuropsychologist (Licence: CA 230000171) | |
| 1041C0700X Social Worker Clinical (Licence: CA 230000171) | |
| 207NP0225X Dermatology Pediatric Dermatology (Licence: CA 230000171) | |
| 207Q00000X Family Medicine (Licence: CA 230000171) | |
| 207R00000X Internal Medicine (Licence: CA 230000171) | |
| 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: CA 230000171) | |
| 207RI0200X Internal Medicine Infectious Disease (Licence: CA 230000171) | |
| 363LF0000X Nurse Practitioner Family (Licence: CA 230000171) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2024-10-16 |