Provider Demographics
NPI:1831272699
Name:SIX RIVERS PLANNED PARENTHOOD
Entity type:Organization
Organization Name:SIX RIVERS PLANNED PARENTHOOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SORENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-442-2961
Mailing Address - Street 1:3225 TIMBERFALL COURT
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503
Mailing Address - Country:US
Mailing Address - Phone:707-442-2961
Mailing Address - Fax:707-445-2019
Practice Address - Street 1:3225 TIMBER FALL CT
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4892
Practice Address - Country:US
Practice Address - Phone:707-442-2961
Practice Address - Fax:707-445-2019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110000100261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ00951ZMedicare ID - Type UnspecifiedSRPP MEDICARE ID