Healthcare Provider Details

I. General information

NPI: 1730359944
Provider Name (Legal Business Name): COUNTY OF TEHAMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 WALNUT ST SUITE C
RED BLUFF CA
96080-3611
US

IV. Provider business mailing address

PO BOX 400
RED BLUFF CA
96080-0400
US

V. Phone/Fax

Practice location:
  • Phone: 530-527-6824
  • Fax: 530-527-0362
Mailing address:
  • Phone: 530-527-8491
  • Fax: 530-528-9460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JAYME S. BOTTKE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 530-527-8491