| Enloe Palliative Care | |
|
1531 Esplanade Chico CA 95926-3310 | |
| (530) 332-7300 | |
| (530) 893-6843 |
| Full Name | Enloe Palliative Care |
|---|---|
| Speciality | Psychologist |
| Location | 1531 Esplanade, Chico, California |
| Authorized Official Name and Position | Kevin Woodward (VP/CFO) |
| Authorized Official Contact | 5303326733 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enloe Palliative Care 1531 Esplanade Attn: Finance Chico CA 95926-3310 Ph: (530) 332-7479 | Enloe Palliative Care 1531 Esplanade Chico CA 95926-3310 Ph: (530) 332-7300 |
| NPI Number | 1861814089 |
|---|---|
| Provider Enumeration Date | 01/07/2014 |
| Last Update Date | 05/29/2020 |
| Certification Date | 05/29/2020 |
| Medicare PECOS PAC ID | 9739092388 |
|---|---|
| Medicare Enrollment ID | O20141001001132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861814089 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 230000027 (California) | Primary |
| Provider Name | Hyung W An |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336108851 PECOS PAC ID: 6204740020 Enrollment ID: I20031120000380 |
| Provider Name | Ahmed Ibrahi Abouesh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487661120 PECOS PAC ID: 6507833993 Enrollment ID: I20041203000817 |
| Provider Name | Todd E Brandtman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336193432 PECOS PAC ID: 7214970508 Enrollment ID: I20050607001337 |
| Provider Name | Alan J Stesin |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1346369709 PECOS PAC ID: 6608897822 Enrollment ID: I20051216000527 |
| Provider Name | Michelle D Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750581492 PECOS PAC ID: 5597853911 Enrollment ID: I20071119000638 |
| Provider Name | Deborah A Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346408473 PECOS PAC ID: 7810057742 Enrollment ID: I20081121000119 |
| Provider Name | Scott Nichols |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295989572 PECOS PAC ID: 8325176316 Enrollment ID: I20100512000827 |
| Provider Name | Samuel A Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396923868 PECOS PAC ID: 5092987602 Enrollment ID: I20111004000122 |
| Provider Name | Asad Amir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285832717 PECOS PAC ID: 9234307570 Enrollment ID: I20120906000805 |
| Provider Name | Lori F Goodliffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942550132 PECOS PAC ID: 2567609738 Enrollment ID: I20130507000269 |
| Provider Name | Vashty A Kyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578825782 PECOS PAC ID: 9234172958 Enrollment ID: I20130520000744 |
| Provider Name | Christine E Brice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467517524 PECOS PAC ID: 6204879562 Enrollment ID: I20141230001449 |
| Provider Name | Karim G Lotfy Mohammed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558657676 PECOS PAC ID: 5991019747 Enrollment ID: I20150806011848 |
| Provider Name | Shauna Winkle Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356789879 PECOS PAC ID: 8729396742 Enrollment ID: I20150924001577 |
| Provider Name | Amy C Micheli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003287608 PECOS PAC ID: 4385952472 Enrollment ID: I20151009002348 |
| Provider Name | Anna Nicole Coates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710380126 PECOS PAC ID: 5395043855 Enrollment ID: I20160415001970 |
| Provider Name | Aldebra L Schroll |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1568417012 PECOS PAC ID: 7214125541 Enrollment ID: I20160826002343 |
| Provider Name | Brandi J Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760936561 PECOS PAC ID: 0446547780 Enrollment ID: I20160929001791 |
| Provider Name | Barbra Q Maguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952834541 PECOS PAC ID: 5092083782 Enrollment ID: I20170621002734 |
| Provider Name | Lynn Gamble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770742884 PECOS PAC ID: 9032452909 Enrollment ID: I20190516000057 |
| Provider Name | Barry Eliot Cole |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114073913 PECOS PAC ID: 7214061969 Enrollment ID: I20200507001395 |
| Provider Name | Jaswinder Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376180448 PECOS PAC ID: 4789015249 Enrollment ID: I20200518000216 |
| Provider Name | Kristina Lyn Roach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629548169 PECOS PAC ID: 1557784154 Enrollment ID: I20200714002883 |
| Provider Name | Bradley Tanner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447348131 PECOS PAC ID: 8325178650 Enrollment ID: I20220413002563 |
| Provider Name | Kati J Boomgarden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326577552 PECOS PAC ID: 1456606870 Enrollment ID: I20230106000925 |
Fee For Service Psychiatrist Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3217 Cohasset Rd, Chico, CA 95973 Phone: 530-891-2980 Fax: 530-895-6548 | |
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