NORTH VALLEY BREAST CLINIC (NPI# 1841494366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841494366 |
| Entity Type | Organization |
| Organization Name | NORTH VALLEY BREAST CLINIC |
| Practice Address |
1335 Buenaventura Blvd Suite # 204 Redding CA 96001-0160 |
| Practice Telephone | 5302435551 |
| Practice Fax Number | 5302450572 |
| Mailing Telephone | 5302435551 |
| Mailing Fax Number | 5302450572 |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2012-07-16 |
| Authorized Official Name | DR. IAN P GRADY (OWNER) |
| Authorized Official Telephone | 5302435551 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | ZZZ53955Y | 01 |
| Street Address |
1335 BUENAVENTURA BLVD SUITE # 204 |
| City | REDDING |
| State | CA |
| Zip Code | 96001-0160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407821317 | Robert M Hansen | Anesthesiology | 1335 Buenaventura Blvd, Suite 100, Redding, CA 96001-0160 | 2006-02-22 |
| 1700022647 | Robert John Ziola | Registered Nurse | 1335 Buenaventura Blvd, Suite 100, Redding, CA 96001-0160 | 2008-12-24 |
| 1720295249 | Therapeutic Pain Management Medical Clinic | Pain Medicine | 1335 Buenaventura Blvd, #100, Redding, CA 96001-0160 | 2007-05-16 |
| 1235220815 | David E Mcgee-williams | Clinical Neuropsychologist | 1335 Buenaventura Blvd, Redding, CA 96001-0160 | 2006-09-27 |
| 1629045125 | Shishir A Dhruva | Anesthesiology | 1335 Buenaventura Blvd, Suite 100, Redding, CA 96001-0160 | 2006-03-02 |
| 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 | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1871975946 | Emergent Neurology & Telemedicine Inc | Clinic/Center | 2371 Eureka Way, Redding, CA 96001-0321 | 2015-06-24 |
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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.