Provider Demographics
NPI:1932855939
Name:PLANNED PARENTHOOD SHASTA DIABLO INC
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD SHASTA DIABLO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERIM DIRECTOR OF HUMAN RESOURCES
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-887-5364
Mailing Address - Street 1:2185 PACHECO ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2309
Mailing Address - Country:US
Mailing Address - Phone:925-348-5597
Mailing Address - Fax:
Practice Address - Street 1:2 H ST FL 1
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-1700
Practice Address - Country:US
Practice Address - Phone:925-887-5233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACDF-90005638OtherSTATE LICENSE