NPIMap

Organization Active NPI

Shasta County Mental Health Burney Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Burney, CA
National Provider Identifier
1316096142
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SHASTA COUNTY MENTAL HEALTH BURNEY CLINIC
Practice address
37497 Enterprise Street
A
Burney, CA 96013
Phone
(530) 335-2906
Fax
(530) 335-2389
NPI assigned
Jan 10, 2007
Organization subpart
Yes
Parent organization
COUNTY OF SHASTAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Authorized official

Name
Mark Montgomery, PSYD
Title
Director of Mental Health
Phone
(530) 225-5200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

37497 Enterprise Street
A
Burney, CA 96013

Mailing address

PO Box 496048
Redding, CA 96049-6048
Phone (530) 225-5200

Other identifiers 1

IdentifierTypeStateIssuer
4581MedicaidCA

Other names 1

  • Shasta County Mental Health Burney Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shasta County Health de33 organizations share this tax ID, including this one
Part of
Shasta County Health de

Other organizations with this tax ID 32

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

View all 32

Locations

37497 Enterprise Dr
#A
Burney, CA 96013
Phone (530) 335-2906

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1316096142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496048",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496048",
            "telephone_number": "530-225-5200",
            "fax_number": "530-225-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37497 ENTERPRISE STREET",
            "address_2": "A",
            "city": "BURNEY",
            "state": "CA",
            "postal_code": "96013",
            "telephone_number": "530-335-2906",
            "fax_number": "530-335-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASTA COUNTY MENTAL HEALTH BURNEY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF SHASTA",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR OF MENTAL HEALTH",
        "authorized_official_telephone_number": "530-225-5200",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4581",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shasta County Mental Health Burney",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burney, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.