Provider Demographics
NPI:1740020510
Name:TEHAMA COUNTY
Entity type:Organization
Organization Name:TEHAMA COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAYME
Authorized Official - Middle Name:S
Authorized Official - Last Name:BOTTKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-527-8491
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-0400
Mailing Address - Country:US
Mailing Address - Phone:530-528-8377
Mailing Address - Fax:
Practice Address - Street 1:550 LAY AVE
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-9849
Practice Address - Country:US
Practice Address - Phone:530-527-8491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEHAMA COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-29
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health