Organization
SHASTA COMMUNITY HEALTH CENTER
Active
Organization
SHASTA COMMUNITY HEALTH CENTER
Active
Other names
Enterprise Family Health & Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERY BRANDON THORNOCK (CEO)
(530) 246-5074
Entity
Organization
Contact information
Practice address
1201 INDUSTRIAL ST, REDDING, CA 96002-0757
(530) 246-5710
Mailing address
PO BOX 992790, REDDING, CA 96099-2790
(530) 246-5710
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
152W00000X
Optometrist
—
—
174400000X
Specialist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
02/12/2020
Last updated
10/16/2024
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