Provider Demographics
NPI:1619070992
Name:DEPARTMENT OF VETERAN AFFAIRS
Entity type:Organization
Organization Name:DEPARTMENT OF VETERAN AFFAIRS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACTING CHIEF OF SOCIAL WORK SERVICE
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BORREGO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:916-843-7383
Mailing Address - Street 1:PO BOX 1895
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-1895
Mailing Address - Country:US
Mailing Address - Phone:530-879-5017
Mailing Address - Fax:530-899-0581
Practice Address - Street 1:280 COHASETT ROAD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95927
Practice Address - Country:US
Practice Address - Phone:530-879-5017
Practice Address - Fax:530-899-0581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALC 13808261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center