Provider Demographics
NPI:1841568094
Name:SHASTA COUNTY
Entity Type:Organization
Organization Name:SHASTA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MENTAL HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:RD, MPH
Authorized Official - Phone:530-245-6750
Mailing Address - Street 1:2640 BRESLAUER
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 1:3711 OASIS RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-0397
Practice Address - Country:US
Practice Address - Phone:530-245-6750
Practice Address - Fax:530-225-5950
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHASTA COUNTY HEALTH AND HUMAN SERVICES AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-02
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health