Provider Demographics
NPI:1043408529
Name:SENECA HEALTHCARE DISTRICT
Entity Type:Organization
Organization Name:SENECA HEALTHCARE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-258-2067
Mailing Address - Street 1:P.O. BOX 737
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:96020
Mailing Address - Country:US
Mailing Address - Phone:530-258-2151
Mailing Address - Fax:530-258-3471
Practice Address - Street 1:130 BRENTWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:CA
Practice Address - Zip Code:96020
Practice Address - Country:US
Practice Address - Phone:530-258-2151
Practice Address - Fax:530-258-3471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230000032282NC0060X, 282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZQ3201ZOtherMEDICARE PART B PHY GRP
CAC40812OtherRR MEDICARE PART B PHY GR
CAGR0093570Medicaid