1437850880 NPI number — GOLD COUNTRY COMMUNITY SERVICES

Table of content: DR. HEATHER MARIE D'ADAMO M.D. (NPI 1871729418)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437850880 NPI number — GOLD COUNTRY COMMUNITY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOLD COUNTRY COMMUNITY SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437850880
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 968
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRASS VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95945-0968
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-615-4541
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
206 PROVIDENCE MINE ROAD
Provider Second Line Business Practice Location Address:
206 PROVIDENCE MINE ROAD, SUITE 118
Provider Business Practice Location Address City Name:
NEVADA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-615-4541
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/13/2023

Additional Information

Authorized Official

Authorized Official Last Name:
LOVEJOY
Authorized Official First Name:
LESLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
530-615-4541

Provider Taxonomy Codes

  • Taxonomy code: 332U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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