Provider Demographics
NPI:1407044175
Name:PLANNED PARENTHOOD SHASTA DIABLO
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD SHASTA DIABLO
Other - Org Name:PLANNED PARENTHOOD NORTHERN CALIFORNIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT ACCESS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-887-5369
Mailing Address - Street 1:2935 BECHELLI LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-1905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2935 BECHELLI LN
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-1905
Practice Address - Country:US
Practice Address - Phone:530-351-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACMM71190FMedicaid