Provider Demographics
NPI:1730824392
Name:CHICO COMMUNITY ACUPUNCTURE INC
Entity type:Organization
Organization Name:CHICO COMMUNITY ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS-LAZARO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:530-345-5300
Mailing Address - Street 1:1815 MANGROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2337
Mailing Address - Country:US
Mailing Address - Phone:530-345-5300
Mailing Address - Fax:
Practice Address - Street 1:1815 MANGROVE AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2337
Practice Address - Country:US
Practice Address - Phone:530-345-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service