NPIMap

Organization Active NPI

Excel Academy Shasta County Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Redding, CA
National Provider Identifier
1629128079
Registry record updated Nov 16, 2010
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
EXCEL ACADEMY SHASTA COUNTY MENTAL HEALTH
Practice address
3711 Oasis Rd
Redding, CA 96003-0397
Phone
(530) 225-5200
Fax
(530) 225-5977
NPI assigned
Jan 10, 2007
Organization subpart
Yes
Parent organization
COUNTY OF SHASTAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

3711 Oasis Rd
Redding, CA 96003-0397

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
4578MedicaidCA

Other names 1

  • Excel Academy 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

3711 Oasis Rd
Redding, CA 96003
Phone (530) 275-5480

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": "1289865600000",
    "number": "1629128079",
    "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": "3711 OASIS RD",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960030397",
            "telephone_number": "530-225-5200",
            "fax_number": "530-225-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL ACADEMY SHASTA COUNTY MENTAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF SHASTA",
        "enumeration_date": "2007-01-10",
        "last_updated": "2010-11-16",
        "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": "4578",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 16, 2010; 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.