Individual
ANTHONY PENCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 INDEPENDENCE CIR, CHICO, CA 95973-0381
(530) 345-1600
Mailing address
10 INDEPENDENCE CIR, CHICO, CA 95973-0381
(530) 345-1600
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-098-4601
NVCSS
CA
Enumeration date
01/23/2017
Last updated
01/23/2017
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