Organization
KARUK TRIBE
Active
Other names
KARUK TRIBAL HEALTH PROGRAM
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN MARY TIRATERRA (BUSINESS OFFICE DIRECTOR)
(530) 493-1600
Entity
Organization
Contact information
Practice address
1515 S OREGON ST, YREKA, CA 96097-3475
(530) 841-3141
(530) 841-5150
Mailing address
PO BOX 1016, HAPPY CAMP, CA 96039-1016
(530) 493-1600
(530) 493-1648
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
1223G0001X
General Practice Dentistry
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730279423
MEDICARE
CA
05
—
1730279423
—
CA
01
—
ZZZ16552Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
10/13/2006
Last updated
05/13/2025
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