Healthcare Provider Details

I. General information

NPI: 1104785328
Provider Name (Legal Business Name): VANESSA OSTER
Entity Type: Individual
Gender:
Sole Proprietor: N

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

3550 CHURN CREEK RD
REDDING CA
96002-2718
US

IV. Provider business mailing address

6060 RIVERSIDE DR
REDDING CA
96001-5043
US

V. Phone/Fax

Practice location:
  • Phone: 530-222-3630
  • Fax:
Mailing address:
  • Phone: 530-200-4744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number10296
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: