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General NPI Number Information
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NPI Number | 1881692390
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Entity Type | Organization
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Legal Business Name | COUNTY OF SHASTA
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 2640 BRESLAUER WAY
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City | REDDING
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State | CA
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Zip | 96001-4246
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Country | US
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Telephone | 530-225-5200
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Fax | 530-225-5977
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Provider Business Mailing Address
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Address Line | PO BOX 496048
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City | REDDING
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State | CA
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Zip | 96049-6048
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Country | US
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Telephone | 530-225-5200
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Fax | 530-225-5977
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Authorized Official
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Title or Position | DIRECTOR OF MENTAL HEALTH
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Name | MIGUEL RODRIGUEZ
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Credential |
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Telephone | 530-225-5965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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