Healthcare Provider Details
I. General information
NPI: 1205785490
Provider Name (Legal Business Name): HIS IDEAS, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/22/2026
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
930 EXECUTIVE WAY STE 200
REDDING CA
96002-0635
US
IV. Provider business mailing address
930 EXECUTIVE WAY STE 200
REDDING CA
96002-0635
US
V. Phone/Fax
- Phone: 530-722-1022
- Fax: 530-722-1058
- Phone: 530-722-1022
- Fax: 530-722-1058
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHANNON
PIERCE
Title or Position: CEO
Credential: M.S. PSY
Phone: 530-528-2938