| Quartz Valley Indian Reservation | |
|
9024 Sniktaw Ln Fort Jones CA 96032-9408 | |
| (530) 468-4470 | |
| (530) 468-4478 |
| Full Name | Quartz Valley Indian Reservation |
|---|---|
| Speciality | Family Medicine |
| Location | 9024 Sniktaw Ln, Fort Jones, California |
| Authorized Official Name and Position | Kyle Nelson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5304684470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quartz Valley Indian Reservation 9024 Sniktaw Ln Fort Jones CA 96032-9408 Ph: (530) 468-4470 | Quartz Valley Indian Reservation 9024 Sniktaw Ln Fort Jones CA 96032-9408 Ph: (530) 468-4470 |
| NPI Number | 1306062419 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 02/04/2019 |
| Medicare PECOS PAC ID | 8325147457 |
|---|---|
| Medicare Enrollment ID | O20080131000298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306062419 | NPI | - | NPPES |
| 1306062419 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Amber Lee Maddox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851168579 PECOS PAC ID: 0143740332 Enrollment ID: I20250218002556 |
Marble Mountain Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11219 N Highway 3, Fort Jones, CA 96032 Phone: 530-468-5766 Fax: 530-468-2023 |