Provider Demographics
NPI:1902183098
Name:DEBORAH ANN HIGER
Entity Type:Organization
Organization Name:DEBORAH ANN HIGER
Other - Org Name:SHASTA FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HIGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-926-4556
Mailing Address - Street 1:725 PINE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT SHASTA
Mailing Address - State:CA
Mailing Address - Zip Code:96067-2133
Mailing Address - Country:US
Mailing Address - Phone:530-926-4556
Mailing Address - Fax:
Practice Address - Street 1:725 PINE ST
Practice Address - Street 2:
Practice Address - City:MOUNT SHASTA
Practice Address - State:CA
Practice Address - Zip Code:96067-2133
Practice Address - Country:US
Practice Address - Phone:530-926-4556
Practice Address - Fax:530-926-4532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-03
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72167364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G721670Medicaid
CA00G721670Medicaid
CAF44886Medicare UPIN