Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 95002506 | CA |
NPI | 1023490125 |
---|---|
Provider Name | Danielle Farris |
First Address | Chico, CA 95928-9199 |
Second Address | Chico, CA 95928-9199 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2015 |
Last Update Date | 24/06/2015 |