FAMILY DYNAMICS RESOURCE CENTER (NPI# 1619272564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619272564 |
| Entity Type | Organization |
| Organization Name | FAMILY DYNAMICS RESOURCE CENTER |
| Practice Address |
3657 Ricardo Ave Redding CA 96002-2627 |
| Practice Telephone | 5302429007 |
| Mailing Telephone | 5302429007 |
| Mailing Fax Number | 5302232027 |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2013-08-06 |
| Authorized Official Name | MRS. SANDRA ANN WILSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5306059902 |
| Authorized Official Credential | MA, LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | LCS22115 | CA | Agencies |
| Y | 251S00000X | Community/Behavioral Health | 49910 | CA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FAMILY DYNAMICS RESOURCE CENTER | 1619272564 | 01 |
| CA | 1 INDIVIDUAL | 1023168259 | 01 |
| CA | 1-INDIVIDUAL | 1942221130 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FAMILY DYNAMICS RESOURCE CENTER | 3657 Ricardo Ave, Redding, CA 96002-2627 |
| Street Address |
3657 RICARDO AVE |
| City | REDDING |
| State | CA |
| Zip Code | 96002-2627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194053116 | Lluvia Hetrick | Social Worker | 3657 Ricardo Ave, Redding, CA 96002-2627 | 2009-12-02 |
| 1366042269 | Christopher Garcia | Marriage & Family Therapist | 3657 Ricardo Ave, Redding, CA 96002-2627 | 2020-10-29 |
| 1306446315 | Shaw Tiefenbach | Marriage & Family Therapist | 3657 Ricardo Ave, Redding, CA 96002-2627 | 2020-10-28 |
| 1801496807 | Kari Hess | Social Worker | 3657 Ricardo Ave, Redding, CA 96002-2627 | 2020-10-28 |
| 1255931259 | Jung Chay | Marriage & Family Therapist | 3657 Ricardo Ave, Redding, CA 96002-2627 | 2020-10-28 |
| 1952901092 | Mattison Wenham | Marriage & Family Therapist | 3657 Ricardo Ave, Redding, CA 96002-2627 | 2020-10-28 |
| 1245864222 | Pamela Politi | Marriage & Family Therapist | 3657 Ricardo Ave, Redding, CA 96002-2627 | 2020-02-27 |
| 1952935934 | Colleen Ogden | Marriage & Family Therapist | 3657 Ricardo Ave, Redding, CA 96002-2627 | 2020-02-27 |
| 1689208662 | Lydia Mcgaffee | Case Manager/Care Coordinator | 3657 Ricardo Ave, Redding, CA 96002-2627 | 2020-02-27 |
| 1033743422 | Sean Mcmasters | Marriage & Family Therapist | 3657 Ricardo Ave, Redding, CA 96002-2627 | 2020-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265048037 | Daniel Eli Bartee | Counselor | 555 Leila Ave #44, Redding, CA 96002 | 2020-09-17 |
| 1407467129 | Drake Exstrom | Dentist | 2315 North Bechelli Ln, Suite A, Redding, CA 96002 | 2020-08-14 |
| 1285123117 | Victor Treatment Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 20846 Clairvaux Drive, Redding, CA 96002 | 2018-05-07 |
| 1528510153 | Daniel Conklin | Pharmacist | 2880 Churn Creek, Redding, CA 96002 | 2016-10-31 |
| 1740653864 | Votc, Inc. | Substance Abuse Rehabilitation Facility | 3590 El Portal Dr., # 7, 8, 9, 10, 15, 16, & 17, Redding, CA 96002 | 2015-11-11 |
| 1801226253 | Katie Marie Mccullough-stubbs | Marriage & Family Therapist | 3300 Church Creek, Redding, CA 96002 | 2013-11-21 |
| 1801234026 | Kathy Lynne Hawk | Community Health Worker | 2051 Hilltop Dr A-13, Redding, CA 96002 | 2013-06-10 |
| 1619247590 | Wright Education Services | Social Worker | 2660 Victor Ave, Redding, CA 96002 | 2012-01-09 |
| 1275828840 | Shannika Tricia Dao | Dentist | 2695 Bechelli Ln, Redding, CA 96002 | 2011-06-13 |
| 1336442664 | Small Talk Pediatric Services, Inc. | Speech-Language Pathologist | 2526 Goodwater Ave., Suite A, Redding, CA 96002 | 2010-12-08 |
| Find all providers in zip 96002 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861988750 | Anka Behavioral Health Incorporated | Community/Behavioral Health | 1786 Vinson Dr, Redding, CA 96003-7950 | 2018-07-03 |
| 1528554417 | Anka Behavioral Health Incorporated | Community/Behavioral Health | 20374 Pickford Way, Redding, CA 96002-9231 | 2018-07-03 |
| 1215441282 | Kings View Corporation | Community/Behavioral Health | 1670 Market St Ste 256, Redding, CA 96001-1046 | 2017-11-28 |
| 1821510652 | County of Shasta | Community/Behavioral Health | 1420 Yuba St, Redding, CA 96001-1032 | 2017-07-13 |
| 1811419658 | County of Shasta | Community/Behavioral Health | 1580 Market St, Redding, CA 96001-1023 | 2017-07-13 |
| 1013438019 | County of Shasta | Community/Behavioral Health | 1411 Yuba St, Redding, CA 96001-1010 | 2017-06-29 |
| 1912262932 | Parent Infant Programs, Inc | Community/Behavioral Health | 2628 Victor Ave, Redding, CA 96002-1454 | 2012-07-05 |
| 1093078586 | Randal Lee Bartholomew | Community/Behavioral Health | 1237 California St., Redding, CA 96001 | 2012-06-19 |
| 1629379011 | Children & Family Services | Community/Behavioral Health | 1313 Yuba St, Redding, CA 96001-1012 | 2010-11-16 |
| 1578685210 | Shasta Treatment Associates | Community/Behavioral Health | 1175 Hartnell Ave, Suite C, Redding, CA 96002-2135 | 2007-04-04 |
| 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.