REDDING RANCHERIA (NPI# 1104859354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104859354 |
| Entity Type | Organization |
| Organization Name | REDDING RANCHERIA |
| Practice Address |
1441 Liberty St Redding CA 96001-0848 |
| Practice Telephone | 5302261753 |
| Practice Fax Number | 5302242723 |
| Mailing Telephone | 5302261753 |
| Mailing Fax Number | 5302242723 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2019-10-07 |
| Authorized Official Name | LORI HERNANDEZ (BILLING MANAGER) |
| Authorized Official Telephone | 5302261740 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
20A7013 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BCP70489F | 05 | |
| CA | HAP70489F | 05 | |
| CA | THP70489F | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386164580 | Redding Rancheria | Clinic/Center | 31660 Hwy 3, Weaverville, CA 96093 | 2017-06-20 |
| 1831724053 | Redding Rancheria | Clinic/Center | 4174 Ashby Ct, Shasta Lake, CA 96019-9215 | 2020-03-09 |
| 1164807533 | Redding Rancheria | Clinic/Center | 3184 Churn Creek Rd, Redding, CA 96002-2122 | 2015-07-27 |
| 1528102282 | Redding Rancheria | Pharmacy | 1441 Liberty St, Redding, CA 96001-0848 | 2007-02-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | REDDING RANCHERIA | 2000 Redding Rancheria Rd, Redding, CA 96001-5528 |
| Street Address |
1441 LIBERTY ST |
| City | REDDING |
| State | CA |
| Zip Code | 96001-0848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275179012 | Jennifer Harmon Boudreaux | Nurse Practitioner | 1441 Liberty St, Redding, CA 96001-0811 | 2019-11-26 |
| 1003384496 | Blake E Lamkin | Dietitian, Registered | 1441 Liberty St, Redding, CA 96001-0811 | 2018-11-05 |
| 1699291591 | Kara Anne Carmona Russell | Social Worker | 1441 Liberty St, Redding, CA 96001-0811 | 2017-08-22 |
| 1255877957 | Tara Mckittrick Braemer | Nurse Practitioner | 1441 Liberty St, Redding, CA 96001-0811 | 2017-01-18 |
| 1831504166 | Peter J Chung | Dentist | 1441 Liberty St, Redding, CA 96001-0811 | 2014-06-25 |
| 1093120313 | Ann Nguyen-chung | Dentist | 1441 Liberty St, Redding, CA 96001-0811 | 2014-06-25 |
| 1124432505 | Michelle Drobny | Family Medicine | 1441 Liberty St, Redding, CA 96001-0811 | 2014-06-13 |
| 1013342419 | Melanie Anne Catalano | Physician Assistant | 1441 Liberty St, Redding, CA 96001-0811 | 2013-09-05 |
| 1194063149 | Gavin Patrick Moloney | Dietitian, Registered | 1441 Liberty St, Redding, CA 96001-0848 | 2013-01-25 |
| 1467799684 | Brittney Ann Chrisler | Pharmacist | 1441 Liberty St, Redding, CA 96001-0848 | 2013-01-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730651266 | Vanessa Louise Banda | Social Worker | 1544 Magnolia Avenue, Redding, CA 96001 | 2018-12-21 |
| 1184194672 | Marie Sherrick | Licensed Vocational Nurse | 2030 Elreno Lane, Redding, CA 96001 | 2018-11-28 |
| 1699257857 | Prorehab Physical Therapy and Sports Performance, Inc | Physical Therapist | 3673 Eureka Way, Redding, CA 96001 | 2018-09-05 |
| 1316456833 | Jennifer Rose Goehring | Counselor | 1310 Continental Street, Redding, CA 96001 | 2017-09-27 |
| 1891224440 | Audrey Cutler | Social Worker | 1313 Yuba St., Redding, CA 96001 | 2017-06-07 |
| 1184167991 | Calafia Holdings LLC | Skilled Nursing Facility | 1836 Gold Street, Redding, CA 96001 | 2016-11-28 |
| 1194272369 | Shasta County | Clinic/Center | 2950 Polk Street, Rooms 2, 3, 4, Redding, CA 96001 | 2016-09-06 |
| 1417329236 | Shari Hayden | Specialist/Technologist, Other | 2111 Air Park Dr, Redding, CA 96001 | 2015-10-21 |
| 1679951982 | Shasta Hearing Aids | Health Maintenance Organization | 900 Butte St, Redding, CA 96001 | 2015-05-07 |
| 1073919171 | Native American Mental Health Services Corporation | Psychiatry & Neurology | 1742 Oregon Street, Redding, CA 96001 | 2014-11-17 |
| Find all providers in zip 96001 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818990 | Hill Country Community Clinic | Clinic/Center | 2710 Eureka Way Ste 1, Redding, CA 96001-0230 | 2019-08-29 |
| 1457844318 | Hill Country Community Clinic | Clinic/Center | 1401 Gold St Ste A, Redding, CA 96001-1937 | 2018-06-14 |
| 1447791348 | Hill Country Community Clinic | Clinic/Center | 2042 Market St, Redding, CA 96001-1926 | 2017-03-13 |
| 1396285755 | Hill Country Community Clinic | Clinic/Center | 317 Lake Blvd, Suite A, Redding, CA 96003-2504 | 2017-03-06 |
| 1588104947 | Hill Country Community Clinic | Clinic/Center | 351 Northpoint Dr, Suite C, Redding, CA 96003-2502 | 2017-03-06 |
| 1689114043 | Hill Country Community Clinic | Clinic/Center | 1401 Gold St Ste B, Redding, CA 96001-1937 | 2017-03-06 |
| 1164807533 | Redding Rancheria | Clinic/Center | 3184 Churn Creek Rd, Redding, CA 96002-2122 | 2015-07-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.