Provider Demographics
NPI:1811154099
Name:SHASTA UNION HIGH SCHOOL DISTRICT
Entity type:Organization
Organization Name:SHASTA UNION HIGH SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL ED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-241-3261
Mailing Address - Street 1:2200 EUREKA WAY STE B
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0337
Mailing Address - Country:US
Mailing Address - Phone:530-241-3261
Mailing Address - Fax:
Practice Address - Street 1:2200 EUREKA WAY STE B
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0337
Practice Address - Country:US
Practice Address - Phone:530-241-3261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASS4570136251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS4570136Medicaid