Cache Creek Lodge

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A03430315 Issued in CA

Legal business name

CACHE CREEK LODGE

Practice address

435 Aspen St
Woodland, CA 95695-2665

Phone

(530) 662-5727

NPI assigned

Jan 26, 2017

Last updated

Jun 22, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

CACHE CREEK LODGE, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gabriel M Smith

Title

Owner/Director

Phone

(530) 662-5727

Specialties & licenses 1

Addresses

Part of

Cache Creek Lodge Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1316484439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 ASPEN ST",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956952665",
            "telephone_number": "530-662-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 ASPEN ST",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956952665",
            "telephone_number": "530-662-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CACHE CREEK LODGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CACHE CREEK LODGE, INC.",
        "enumeration_date": "2017-01-26",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "530-662-5727"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A03430315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Burgren
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• Cache Creek Lodge Inc
• Cache Creek Lodge, Inc.
• Cache Creek Lodge, Inc.
• Loren Andrew Cadelinia, D.D.S, M.S.
• Evelyn Joyce Calayag, D.D.S.

• Addiction (Substance Use Disorder) Counselor in Woodland, CA
• Providers in Woodland, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.