Cancer Care Consultants of Northern California a Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CANCER CARE CONSULTANTS OF NORTHERN CALIFORNIA A MEDICAL GROUP

Practice address

902 Pine St
Mount Shasta, CA 96067-2143

Phone

(530) 926-7234

Fax

(530) 926-7231

NPI assigned

Aug 10, 2006

Last updated

Nov 8, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Stahl

Title

Office Manger

Phone

(530) 244-2223

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1982615779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 993100",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960993100",
            "telephone_number": "530-244-2223",
            "fax_number": "530-244-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 PINE ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960672143",
            "telephone_number": "530-926-7234",
            "fax_number": "530-926-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER CARE CONSULTANTS OF NORTHERN CALIFORNIA A MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "STAHL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANGER",
        "authorized_official_telephone_number": "530-244-2223"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0054240",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Michelle Burleigh, PHARMD
• Dancing Ember Butler
• Sariya Butler
• Evelyn Ridenhour Callas, M.D.
• Amy Summer Cambou, BCBA
• John Karl Capos, D.O.
• Carrie Lynn Carlin, MD
• Christopher Carney, D.D.S.
• Stacy Carter
• Christina Caselli, N.D.

• Specialist in Mount Shasta, CA
• Providers in Mount Shasta, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.