Organization
AMPLA HEALTH
Active
Other names
Ampla Health Family Dental & Medical
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L CHISSIE (BILLING ACCOUNT MANAGER)
(530) 751-3778
Entity
Organization
Contact information
Practice address
285 COHASSET RD, CHICO, CA 95926-5513
(530) 342-6065
Mailing address
PO BOX AD, YUBA CITY, CA 95992-1396
(530) 751-3778
(530) 751-1237
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550001829
CALIF DEPT OF PUBLIC HEALTH
CA
05
—
FHC70485F
—
CA
Enumeration date
07/19/2006
Last updated
07/03/2024
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