Healthcare Provider Details

I. General information

NPI: 1164319679
Provider Name (Legal Business Name): SHASTA COUNTY CHILD ABUSE PREVENTION COORDINATING COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2280 BENTON DR BLDG B& C
REDDING CA
96003-5349
US

IV. Provider business mailing address

2280 BENTON DR BLDG C
REDDING CA
96003-5349
US

V. Phone/Fax

Practice location:
  • Phone: 530-242-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNA BERRY
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 530-806-0880