Healthcare Provider Details

I. General information

NPI: 1699674242
Provider Name (Legal Business Name): INTEGRATED COMPLEX CARE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 EAST ST STE 300B
REDDING CA
96001-1160
US

IV. Provider business mailing address

1555 EAST ST STE 300B
REDDING CA
96001-1160
US

V. Phone/Fax

Practice location:
  • Phone: 530-242-4683
  • Fax:
Mailing address:
  • Phone: 530-242-4683
  • Fax:

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: JACOB HALPERT
Title or Position: ACCESS MANAGER
Credential:
Phone: 607-738-6356