Healthcare Provider Details

I. General information

NPI: 1972653343
Provider Name (Legal Business Name): CATALYST SHASTA COUNTY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 10/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 8TH ST
REDDING CA
96001-0365
US

IV. Provider business mailing address

PO BOX 496048
REDDING CA
96049-6048
US

V. Phone/Fax

Practice location:
  • Phone: 530-225-5200
  • Fax:
Mailing address:
  • Phone: 530-225-5200
  • Fax: 530-225-5977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARK MONTGOMERY
Title or Position: DIRECTOR OF MENTAL HEALTH
Credential: PSYD
Phone: 530-225-5200