Provider Demographics
NPI:1881782639
Name:SISKIYOU COUNTY PUBLIC HEALTH DEPARTMENT
Entity type:Organization
Organization Name:SISKIYOU COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:STUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-841-2134
Mailing Address - Street 1:810 S. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097
Mailing Address - Country:US
Mailing Address - Phone:530-841-2134
Mailing Address - Fax:530-841-4092
Practice Address - Street 1:810 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097
Practice Address - Country:US
Practice Address - Phone:530-841-2134
Practice Address - Fax:530-841-4092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEXE70005FMedicare ID - Type UnspecifiedMEDI-CAL PROVIDER NUMBER