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572 Rio Lindo Ave Ste 203 Chico CA 95926-1851 | |
(520) 815-4328 | |
(530) 636-4772 |
Full Name | |
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Speciality | Social Worker |
Location | 572 Rio Lindo Ave Ste 203, Chico, California |
Authorized Official Name and Position | Ta'shanne Horn (OWNER/PROVIDER) |
Authorized Official Contact | 5308154328 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 8959 Chico CA 95927-8959 Ph: (530) 815-4328 | 572 Rio Lindo Ave Ste 203 Chico CA 95926-1851 Ph: (520) 815-4328 |
NPI Number | 1952083479 |
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Provider Enumeration Date | 08/03/2023 |
Last Update Date | 10/02/2023 |
Certification Date | 10/02/2023 |
Medicare PECOS PAC ID | 0941658975 |
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Medicare Enrollment ID | O20231130002632 |
Identifier | Type | State | Issuer |
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1952083479 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Ta'shanne Watu Horn |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1568620342 PECOS PAC ID: 9436485109 Enrollment ID: I20190802000044 |
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