NPIMap

Organization Active NPI

County of Siskiyou

Doing business as County of Siskiyou Behavioral Health

  • Community/Behavioral Health Agency
  • Yreka, CA
National Provider Identifier
1780803239
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNTY OF SISKIYOU
Doing business as
County of Siskiyou Behavioral Health
Practice address
2060 Campus Dr
Yreka, CA 96097-9538
Phone
(530) 841-4100
Fax
(530) 841-4230
NPI assigned
Apr 24, 2007
Last updated
May 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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

Authorized official

Name
Rose Marie Bullock
Title
Administrative Services Manager
Phone
(530) 841-4732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2060 Campus Dr
Yreka, CA 96097-9538

Mailing address

2060 Campus Dr
Yreka, CA 96097-9538
Phone (530) 841-4100

Other names 1

  • County of Siskiyou Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121207000287 CA Part B Supplier - Clinic/Group Practice 8224280706 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: Mount Shasta, CA; Yreka, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • County of Siskiyou

    dba County of Siskiyou Behavioral Health Services

    • Community/Behavioral Health Agency
    • Mount Shasta, CA
    • NPI 1427219237

    O20121207000287

    Same enrollment

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1780803239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 CAMPUS DR",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960979538",
            "telephone_number": "530-841-4100",
            "fax_number": "530-841-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 CAMPUS DR",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960979538",
            "telephone_number": "530-841-4100",
            "fax_number": "530-841-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SISKIYOU",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2024-05-03",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES MANAGER",
        "authorized_official_telephone_number": "530-841-4732"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "County of Siskiyou Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yreka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.