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Organization
QUARTZ VALLEY INDIAN RESERVATION
Active
Organization
QUARTZ VALLEY INDIAN RESERVATION
Active
Other names
ANAV TRIBAL HEALTH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE NELSON MSW, MPH (EXECUTIVE DIRECTOR)
(530) 468-4470
Entity
Organization
Contact information
Practice address
9024 SNIKTAW LN, FORT JONES, CA 96032-9408
(530) 468-4470
(530) 468-4478
Mailing address
9024 SNIKTAW LN, FORT JONES, CA 96032-9408
(530) 468-4470
(530) 468-4478
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306062419
—
CA
Enumeration date
04/17/2007
Last updated
02/04/2019
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