Provider Demographics
NPI:1518362680
Name:REMI VISTA INC
Entity Type:Organization
Organization Name:REMI VISTA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MONSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-245-5808
Mailing Address - Street 1:PO BOX 494100
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-4100
Mailing Address - Country:US
Mailing Address - Phone:530-245-5805
Mailing Address - Fax:530-245-0340
Practice Address - Street 1:2701 PARK MARINA DR
Practice Address - Street 2:3RD FLOOR
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2805
Practice Address - Country:US
Practice Address - Phone:530-245-5805
Practice Address - Fax:530-245-0340
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REMI VISTA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-30
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X, 106H00000X
CA28502103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty