# DIGNITY HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DIGNITY HEALTH
- **Other names:** Pine Street Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1942632534
- **Legal business name:** DIGNITY HEALTH
- **Authorized official:** KIM MIRANDA (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (530) 225-6121

## Contact information

- **Practice address:** 408 PINE ST, MOUNT SHASTA, CA 96067-2126
- **Practice address phone:** (530) 926-6111
- **Practice address fax:** (530) 926-0517
- **Mailing address:** 3400 DATA DR, 1ST FLOOR, RANCHO CORDOVA, CA 95670-7956
- **Mailing address phone:** (530) 225-6300
- **Mailing address fax:** (530) 225-7278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/06/2013
- **Last updated:** 10/31/2016