Healthcare Provider Details

I. General information

NPI: 1467368951
Provider Name (Legal Business Name): PRIMARY CARE HEALTH SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 HILLTOP DR
REDDING CA
96002-0507
US

IV. Provider business mailing address

2405 HILLTOP DR
REDDING CA
96002-0507
US

V. Phone/Fax

Practice location:
  • Phone: 530-338-2090
  • Fax: 530-338-2098
Mailing address:
  • Phone: 530-338-2090
  • Fax: 530-338-2098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NTANGO DESIRE BANANI
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 229-339-0059