# KARUK TRIBE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KARUK COMMUNITY HEALTH CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952483406
- **Authorized official:** EILEEN MARY TIRATERRA (BUSINESS OFFICE DIRECTOR)
- **Authorized official phone:** (530) 493-1600

## Contact information

- **Practice address:** 64105 HILLSIDE ROAD, HAPPY CAMP, CA 96039
- **Practice address phone:** (530) 493-1450
- **Practice address fax:** (530) 493-1451
- **Mailing address:** PO BOX 1016, HAPPY CAMP, CA 96039-1016
- **Mailing address phone:** (530) 493-5257
- **Mailing address fax:** (530) 493-5270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | CA | — |
| 1223G0001X | General Practice Dentistry | — | CA | — |
| 208D00000X | General Practice Physician | — | CA | Yes |

## Other

- **Enumeration date:** 10/20/2006
- **Last updated:** 01/30/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1952483406 | MEDICARE | CA |
| 05 | — | 1952483406 | — | CA |
| 01 | — | ZZZ09861Z | BLUE SHIELD OF CALIFORNIA | CA |