NPIMap

Organization Active NPI

Shasta County

  • Adolescent and Children Mental Health Clinic/Center
  • Redding, CA
National Provider Identifier
1023395662
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
SHASTA COUNTY
Practice address
1620/1624 Market St
Redding, CA 96001-1021
Phone
(530) 245-6750
Fax
(530) 225-5950
NPI assigned
Nov 10, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SHASTA COUNTY HEALTH AND HUMAN SERVICES AGENCYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Donnell Ewert, M.P.H
Title
Director of Mental Health
Phone
(530) 245-6750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

1620/1624 Market St
Redding, CA 96001-1021

Mailing address

2640 Breslauer
Redding, CA 96001-1021
Phone (530) 245-6750

National Provider Directory

National Provider Directory
Tax ID family
Shasta Gen Hosp Dept of33 organizations share this tax ID, including this one
Part of
Shasta Gen Hosp Dept of

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1023395662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 BRESLAUER",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011021",
            "telephone_number": "530-245-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620/1624 MARKET ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011021",
            "telephone_number": "530-245-6750",
            "fax_number": "530-225-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASTA COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHASTA COUNTY HEALTH AND HUMAN SERVICES AGENCY",
        "enumeration_date": "2011-11-10",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "EWERT",
        "authorized_official_first_name": "DONNELL",
        "authorized_official_title_or_position": "DIRECTOR OF MENTAL HEALTH",
        "authorized_official_telephone_number": "530-245-6750",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.P.H"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.