Provider Demographics
NPI:1679850358
Name:SHASTA COUNTY
Entity Type:Organization
Organization Name:SHASTA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DORNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-225-3749
Mailing Address - Street 1:2640 BRESLAUER WAY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1021
Mailing Address - Country:US
Mailing Address - Phone:530-245-6750
Mailing Address - Fax:530-225-5950
Practice Address - Street 1:43 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-2807
Practice Address - Country:US
Practice Address - Phone:530-225-5252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF SHASTA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-09
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health