SHASTA COMMUNITY HEALTH CENTER (NPI# 1164848487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164848487 |
| Entity Type | Organization |
| Organization Name | SHASTA COMMUNITY HEALTH CENTER |
| Practice Address |
1035 Placer St Redding CA 96001-1125 |
| Mailing Address |
Po Box 992790 Redding CA 96099-2790 |
| Practice Telephone | 5302475710 |
| Mailing Telephone | 5302475710 |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2014-03-11 |
| Authorized Official Name | C. DEAN GERMANO (CEO) |
| Authorized Official Telephone | 5302475710 |
| Authorized Official Credential | MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013931476 | Shasta Community Health Center | Physician Assistant | 16300 Cloverdale Rd, Anderson, CA 96007-8209 | 2006-07-27 |
| 1538181557 | Shasta Community Health Center | Dentist | 1400 Market Street, Redding, CA 96001 | 2006-07-25 |
| 1013932797 | Shasta Community Health Center | Dentist | 4215 Front St, Shasta Lake, CA 96019-9430 | 2006-07-13 |
| 1942225719 | Shasta Community Health Center | Dentist | 2801 Silver St, Anderson, CA 96007-4239 | 2006-07-13 |
| 1114533171 | Shasta Community Health Center | Internal Medicine | 1756 Continental St, Redding, CA 96001-1240 | 2020-09-16 |
| 1669004123 | Shasta Community Health Center | Social Worker | 3270 Churn Creek Rd, Redding, CA 96002-2504 | 2020-02-12 |
| 1356815542 | Shasta Community Health Center | Social Worker | 980 Placer St, Redding, CA 96001-1126 | 2019-01-22 |
| 1710450929 | Shasta Community Health Center | Obstetrics & Gynecology | 1900 Railroad Ave, Redding, CA 96001-1802 | 2019-01-10 |
| 1699171660 | Shasta Community Health Center | Social Worker | 3184 Churn Creek Rd, Redding, CA 96002-2122 | 2014-11-18 |
| 1417033614 | Shasta Community Health Center | Health Maintenance Organization | 1035 Placer St, Redding, CA 96001-1125 | 2006-10-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SHASTA COMMUNITY HEALTH CENTER | 1035 Placer St, Redding, CA 96001-1125 |
| Street Address |
1035 PLACER ST |
| City | REDDING |
| State | CA |
| Zip Code | 96001-1125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407840895 | Jeffrey A Bosworth | Family Medicine | 1035 Placer St, Redding, CA 96001-1125 | 2005-08-31 |
| 1669086849 | Morgan Borges | Registered Nurse | 1035 Placer St, Redding, CA 96001-1170 | 2020-09-03 |
| 1417569575 | Breanna Marie Lazar | Nurse Practitioner | 1035 Placer St, Redding, CA 96001-1170 | 2020-08-20 |
| 1548872591 | Emily Ann Bollin | Registered Nurse | 1035 Placer St, Redding, CA 96001-1170 | 2020-08-20 |
| 1144847351 | Christa Mckenzie | Nurse Practitioner | 1035 Placer St, Redding, CA 96001-1170 | 2020-07-03 |
| 1013539824 | Reisa Rara | Student in an Organized Health Care Education/Training Program | 1035 Placer St, Redding, CA 96001-1170 | 2020-05-14 |
| 1912536798 | Muhammad Kamal Iftikhar | Student in an Organized Health Care Education/Training Program | 1035 Placer St, Redding, CA 96001-1170 | 2020-04-03 |
| 1043847338 | Kari Michelle Barnard | Student in an Organized Health Care Education/Training Program | 1035 Placer St, Redding, CA 96001-1170 | 2020-03-25 |
| 1790312098 | Landin Hagge | Student in an Organized Health Care Education/Training Program | 1035 Placer St, Redding, CA 96001-1170 | 2020-03-25 |
| 1730711516 | Taylor Marie Cardoza | Nurse Practitioner | 1035 Placer St, Redding, CA 96001-1170 | 2020-02-10 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013253921 | William Jude Mccabe | Family Medicine | 13490 Tierra Heights Rd, Redding, CA 96003-7481 | 2012-12-20 |
| 1366709883 | Joe Carroll O'banion | Family Medicine | 910 Hallmark Dr, Redding, CA 96001-0149 | 2012-04-20 |
| 1235409723 | Cristine Osborne | Family Medicine | 2941 Montana Sky Dr, Redding, CA 96002-5155 | 2011-12-30 |
| 1235429572 | Jesse Graham Livingston | Family Medicine | 3611 Steamboat St, Redding, CA 96003-5317 | 2011-04-07 |
| 1285868323 | Julie Jeyaratnam | Family Medicine | 2510 Airpark Dr Ste 201, Redding, CA 96001-2461 | 2009-05-04 |
| 1174785489 | Maria De Lourdes Nicora Bia | Family Medicine | 100 East Cypress, Redding, CA 96002-0000 | 2008-06-27 |
| 1881716256 | Morris Robert Ballard | Family Medicine | 1115 Whiskeytown Ct # B, Redding, CA 96001-0227 | 2007-04-04 |
| 1477673770 | John Elazegui Nepomuceno | Family Medicine | 1520 Collyer Dr, Redding, CA 96003-9535 | 2007-03-30 |
| 1801912332 | The Family Practice Center | Family Medicine | 3310 Churn Creek Rd Ste B, Redding, CA 96002-2513 | 2007-03-22 |
| 1013061647 | Randall James Lankford | Family Medicine | 5814 Old Barn Way, Redding, CA 96001-4654 | 2007-01-22 |
| Find all providers in REDDING | ||||
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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.