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Contact Information

CHARLES L ENOMOTO SR
20 LAKE BLVD
REDDING, CA96003-2512
 Phone: 530-229-1416
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
 

Pastoral

101YP1600X
Indicates primary specialty

NPI Profile & details for CHARLES L ENOMOTO SR · (Male)

NPI # 1760125843
Status Active
Credentials
Entity Individual
Enumeration date 04/18/2022
Last updated 04/18/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # A057340620
  • CA Other 1912215492 TRI-WEST
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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