MEDICARE: CALIFORNIA HERITAGE YOUTHBUILD ACADEMY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1215883848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA HERITAGE YOUTHBUILD ACADEMY

Provider Business Mailing Address
First Line	:	2150 CHURN CREEK RD STE 150
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96002-0756
Country	:	US
Telephone Number	:	530-605-4900
Fax Number	:	530-605-4902

Provider Business Practice Location Address
First Line	:	2150 CHURN CREEK RD STE 150
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96002-0756
Country	:	US
Telephone Number	:	530-605-4900
Fax Number	:	530-605-4902

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CATHY TAYLOR
Credential	:
Telephone Number	:	530-605-4900

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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