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General NPI Number Information
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NPI Number | 1164611232
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Entity Type | Organization
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Legal Business Name | SHASTA WOMEN'S CARE,INC
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 2888 EUREKA WAY STE 201
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City | REDDING
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State | CA
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Zip | 96001-0210
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Country | US
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Telephone | 530-243-0303
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 992920
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City | REDDING
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State | CA
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Zip | 96099-2920
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Country | US
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Telephone | 530-243-0303
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. BARBARA ANN SMITH
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Credential |
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Telephone | 530-229-1855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G84357
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License Number State | CA
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