SHASTA COMMUNITY COLLEGE - STUDENT HEALTH SERVICES


Address: 11555 Old Oregon Trl, Redding, CA 96003-7692
Phone: 5302427580

SHASTA COMMUNITY COLLEGE - STUDENT HEALTH SERVICES (NPI# 1033320726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033320726
Entity Type Organization
Organization Name SHASTA COMMUNITY COLLEGE - STUDENT HEALTH SERVICES
Practice Address 11555 Old Oregon Trl
Redding
CA 96003-7692
Practice Telephone 5302427580
Practice Fax Number 5302254968
Mailing Telephone 5302427580
Mailing Fax Number 5302254968
Enumeration Date 2007-05-24
Last Update Date 2020-08-22
Authorized Official Name DR. JULIAN FUENTES (CONTRACTED PHYSICIAN)
Authorized Official Telephone 5302427580
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QS1000X Clinic/Center
Specialization: Student Health
G45631 CA Ambulatory Health Care Facilities

Office Location

Street Address 11555 OLD OREGON TRL
City REDDING
State CA
Zip Code 96003-7692

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1144882309 Patricia Price Social Worker 2280 Benton Dr Building C, Suite A, Redding, CA 96003 2019-07-08
1487102745 Jill Marie Shepherd Piercy Clark Psychologist 1465 Victor Ave Ste B, Redding, CA 96003 2016-09-15
1811344450 Roger Milton Slagle Social Worker 999 Mission De Oro Dr Ste 103, Redding, CA 96003 2016-05-23
1265713812 Tesha Marie Huston Pharmacist 975 Cypress Ave, Redding, CA 96003 2011-09-08
1861717605 Western Physical Therapy Inc Physical Therapist 1495 Victor Ave, Suite D, Redding, CA 96003 2010-04-05
1013230036 Douglas Norman Porter Psychologist 748 North Market St., Redding, CA 96003 2010-03-04
1821232877 Express Medi-trans, Inc. Non-emergency Medical Transport (VAN) 2985 Innsbruck Dr, Redding, CA 96003 2009-04-21
1235393000 Bridget Gabrielle Young Physical Therapist 2021 Benton Dr, Redding, CA 96003 2008-07-10
1447427406 Terra Bella Communities Nursing Facility/Intermediate Care Facility 280 Riverpark Drive, Redding, CA 96003 2008-05-09
1588830657 Terra Bella Communities Intermediate Care Facility, Mentally Retarded 237 Shadowrun Ct., Redding, CA 96003 2008-05-07
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Taxonomy Information

Taxonomy Code 261QS1000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Student Health

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1811452493 Wonderful Center for Health Innovation Inc Clinic/Center 2070 Veneto St, Delano, CA 93215-9122 2019-02-07
1386134815 Ventura County Community College District Clinic/Center 4667 Telegraph Road, Ventura, CA 93003-3872 2018-05-10
1104339761 Kern Community College District Clinic/Center 1801 Panorama Dr, Bakersfield, CA 93305-1219 2017-11-06
1104342393 Yosemite Community College District Clinic/Center 11600 Columbia College Dr, Sonora, CA 95370-8560 2017-08-18
1750813663 Yosemite Community College District Clinic/Center 435 College Ave, Modesto, CA 95350-5808 2017-03-30
1275937682 Emmons Student Wellness Center Clinic/Center 1600 Campus Rd # F-57, Emmons Wellness Center, Los Angeles, CA 90041-3314 2014-10-14
1083036495 Nora Anderson Clinic/Center 1603 Merion Way, 42 G, Seal Beach, CA 90740-4984 2014-01-21
1386082766 Esteban E. Torres High School Clinic Clinic/Center 4127 East Cesar Chavez Avenue, Los Angeles, CA 90063 2013-06-07
1770920787 Allan Hancock College Clinic/Center 800 S College Dr, Santa Maria, CA 93454-6399 2013-05-30
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Competitor

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City REDDING
Zip Code 96003

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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