SHASTA COMMUNITY HEALTH CENTER NPI 1013932797

NPI Information

NPI: 1013932797
Provider Name: SHASTA COMMUNITY HEALTH CENTER

Other Name: SHASTA LAKE CITY FAMILY HEALTH CENTER/DENTAL CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
4215 FRONT ST
SHASTA LAKE, CA
ZIP 96019
Phone: (530) 246-5896
Get Directions

SHASTA COMMUNITY HEALTH CENTER is a family medicine in Shasta Lake, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SHASTA COMMUNITY HEALTH CENTER NPI is 1013932797. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Shasta Lake City Family Health Center/dental Center.

The provider's business location address is:

4215 FRONT ST
SHASTA LAKE, CA
ZIP 96019-430
Phone: (530) 246-5896
Fax: (530) 241-7838

The provider's authorized official is Dean C. Germano .
The authorized official title is Chief Executive Officer and has the following contact phone number (530) 246-5726.

The enumeration date for this NPI number is 7/13/2006 and was last updated on 1/14/2010.

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	License Number	License State	Primary
1	122300000X	Dentist		230000325	CALIFORNIA	No
2	363AM0700X	Physician Assistant	Medical	230000325	CALIFORNIA	No
3	363LF0000X	Nurse Practitioner	Family	230000325	CALIFORNIA	No
4	207Q00000X	Family Medicine		230000325	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	FHC70877F	OTHER	CALIFORNIA	SCHC-SLC MEDI-CAL NUMBER
2	55-1888	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	SCHC-SLC MEDICARE NUMBER

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: 11/14/2023

NPI Synchronization or Removal

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