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General NPI Number Information
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NPI Number | 1780803239
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Entity Type | Organization
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Legal Business Name | COUNTY OF SISKIYOU
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 05/03/2024
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Provider Practice Location Address
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Address Line | 2060 CAMPUS DR
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City | YREKA
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State | CA
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Zip | 96097-9538
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Country | US
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Telephone | 530-841-4100
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Fax | 530-841-4230
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Provider Business Mailing Address
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Address Line | 2060 CAMPUS DR
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City | YREKA
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State | CA
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Zip | 96097-9538
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Country | US
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Telephone | 530-841-4100
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Fax | 530-841-4230
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Authorized Official
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Title or Position | ADMINISTRATIVE SERVICES MANAGER
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Name | ROSE MARIE BULLOCK
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Credential |
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Telephone | 530-841-4732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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