Provider Demographics
NPI:1558420695
Name:PLANNED PARENTHOOD SHASTA DIABLO INC
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD SHASTA DIABLO INC
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 1:2185 PACHECO ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2309
Mailing Address - Country:US
Mailing Address - Phone:925-676-0505
Mailing Address - Fax:
Practice Address - Street 1:3100 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-0962
Practice Address - Country:US
Practice Address - Phone:530-342-8367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
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
CACMM70202FMedicaid
CACMM70202FMedicaid