SHASTA COMMUNITY HEALTH CENTER NPI 1669004123

NPI Information

NPI: 1669004123
Provider Name: SHASTA COMMUNITY HEALTH CENTER

Doing Business As: ENTERPRISE FAMILY HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
3270 CHURN CREEK RD
REDDING, CA
ZIP 96002
Phone: (530) 246-5710
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SHASTA COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Redding, CA. SHASTA COMMUNITY HEALTH CENTER NPI is 1669004123. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Enterprise Family Health Center.

The provider's business location address is:

3270 CHURN CREEK RD
REDDING, CA
ZIP 96002-504
Phone: (530) 246-5710

The provider's authorized official is Brandon Thornock .
The authorized official title is Ceo and has the following contact phone number (530) 246-5074.

The CLIA number assigned to this NPI record is 05D0618142 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/12/2020 and was last updated on 4/16/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	1041C0700X	Social Worker	Clinical	No
2	152W00000X	Optometrist		No
3	174400000X	Specialist		No
4	207Q00000X	Family Medicine		No
5	207R00000X	Internal Medicine		No
6	207W00000X	Ophthalmology		No
7	2084P0800X	Psychiatry & Neurology	Psychiatry	No
8	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	No
9	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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