Basic Information
Provider Information
NPI: 1669660288
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUBER
FirstName: HEATHER
MiddleName: DAWN
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1233 WHITEWOOD WAY
Address2:  
City: CHICO
State: CA
PostalCode: 959738201
CountryCode: US
TelephoneNumber: 5308643956
FaxNumber:  
Practice Location
Address1: 592 RIO LINDO AVE
Address2:  
City: CHICO
State: CA
PostalCode: 959261817
CountryCode: US
TelephoneNumber: 5308912999
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/09/2007
LastUpdateDate: 08/12/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X24165CAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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