Organization
SHASTA COMMUNITY HEALTH CENTER
Active
Parent organization
SHASTA COMMUNITY HEALTH CENTER
Other names
Anderson Family Health & Dental Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHASTA COMMUNITY HEALTH CENTER
Authorized official
MR. JEFFERY BRANDON THORNOCK (CEO)
(530) 229-5074
Entity
Organization
Contact information
Practice address
2965 EAST ST, ANDERSON, CA 96007-3481
(530) 378-0486
(530) 241-7838
Mailing address
PO BOX 992790, REDDING, CA 96099-2790
(530) 378-0486
(530) 241-7838
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
230000287
CA
207Q00000X
Family Medicine Physician
230000287
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363A00000X
Physician Assistant
230000287
CA
363LF0000X
Family Nurse Practitioner
230000287
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FHC70765F
SCHC-ANDY MEDI-CAL NUMBER
CA
Enumeration date
07/13/2006
Last updated
10/16/2024
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