Shasta Lake City Family Health Center/Dental Center

LBN: Shasta Community Health Center
Shasta Lake City Family Health Center/Dental Center is an health care organization with primary practice located at 4215 Front St , Shasta Lake CA 96019-9430. The organization recently has 5 registered licenses in different health care specialties including Dental Providers / Dentist, Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Family. Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Shasta Community Health Center can be contacted via phone (530) 246-5896, or through Thornock, Brandon via phone (530) 246-5074.

Contact Information

Primary practice address
4215 Front St Shasta Lake CA 96019-9430
Phone: (530) 246-5896
Fax: (530) 241-7838
Website:
Map and Directions
Authorized official contact:
Name: Thornock, Brandon
Phone: (530) 246-5074

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 230000325 California
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 230000325 California
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 230000325 California
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 230000325 California

Profile Details

NPI number 1013932797
LBN Legal business name Shasta Community Health Center
DBA Doing business as Shasta Lake City Family Health Center/Dental Center
Authorized official Thornock, Brandon
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 13th, 2006
Last updated Apr 16th, 2024 - about 7 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013932797 NPPES
California Other FHC70877F SCHC-SLC MEDI-CAL NUMBER

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