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General NPI Number Information
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NPI Number | 1013853910
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Entity Type | Organization
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Legal Business Name | SISKIYOU WELLNESS COMMUNITY MENTAL HEALTH
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Dates
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Enumeration Date | 04/24/2026
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Last Update Date | 04/24/2026
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Provider Practice Location Address
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Address Line | 1341 VISTA DR
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City | MOUNT SHASTA
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State | CA
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Zip | 96067-9778
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Country | US
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Telephone | 530-918-8545
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Fax |
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Provider Business Mailing Address
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Address Line | 404 N MOUNT SHASTA BLVD # 155
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City | MOUNT SHASTA
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State | CA
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Zip | 96067-2232
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISS RAMALEE HARNISH
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Credential | LMFT
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Telephone | 530-918-8545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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