| NPI | 1114533171 |
|---|---|
| Doing Business As | SHASTA COMMUNITY TELEMEDICINE AND TRAINING CENTER |
| Entity Type | Organization |
| Authorized Contact | JEFFERY BRANDON THORNOCK Chief Executive Officer 530-246-5074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2024-10-16 |