Basic Information
| Provider Information | |||||||||
| NPI: | 1770679656 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FEATHER RIVER HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5974 PENTZ ROAD | ||||||||
| Address2: | |||||||||
| City: | PARADISE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95969 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308779361 | ||||||||
| FaxNumber: | 5308767943 | ||||||||
| Practice Location | |||||||||
| Address1: | 5974 PENTZ RD | ||||||||
| Address2: | |||||||||
| City: | PARADISE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959695509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308779361 | ||||||||
| FaxNumber: | 5308767943 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KELLY | ||||||||
| AuthorizedOfficialFirstName: | MARGARET | ||||||||
| AuthorizedOfficialMiddleName: | JUANITA | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF CLINICAL DIETITIAN | ||||||||
| AuthorizedOfficialTelephone: | 5308779361 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | M.S., R.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 884510 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.