Organization
REDDING RANCHERIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI HERNANDEZ (BILLING MANAGER)
(530) 226-1740
Entity
Organization
Contact information
Practice address
1441 LIBERTY ST, REDDING, CA 96001-0811
(530) 226-1753
(530) 224-2723
Mailing address
1441 LIBERTY ST, REDDING, CA 96001-0848
(530) 226-1753
(530) 224-2723
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
20A7013
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BCP70489F
—
CA
05
—
HAP70489F
—
CA
05
—
THP70489F
—
CA
Enumeration date
07/09/2006
Last updated
09/21/2021
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