Organization, Name | Practice Address | Practice Phone | Taxonomy | NPI |
Agu, Stanley | 5350 Shasta Dam Blvd Shasta Lake CA 96019-9402 | 530-275-1532 | 183500000X | 1659826584 |
Allen, Dr. Diane E D.D.S. | 4340 Shasta Dam Blvd Shasta Lake CA 96019-9420 | 530-275-3077 | 1223G0001X | 1457337248 |
OTHER CA LICENSE NUMBER : 26802 |
Baas, Donald Roy P.T. | 5061 Shasta Dam Blvd Shasta Lake CA 96019-9422 | 530-275-0777 | 225100000X | 1245268317 |
MEDICAID WA : 7115371 |
Baas, Erin Marie PT | 5061 Shasta Dam Blvd Shasta Lake CA 96019-9422 | 530-275-0777 | 225100000X | 1427253699 |
Bann, Mr. Wayne | 5350 Shasta Dam Blvd Shasta Lake CA 96019-9402 | 530-275-1532 | 183500000X | 1447486733 |
Budhram, Dr. Harold S. M.D | 5145 Shasta Dam Blvd Shasta Lake CA 96019-9403 | 530-275-5421 | 207Q00000X | 1871518761 |
OTHER CA STATE ID : G31973 || MEDICAID CA : RHM53954F || OTHER CA TAX ID# : 68-0188060 || OTHER CA DEA # : AB7238428 |
Bullock, Katie LMFT | 5232 Shasta Dam Blvd Ste C Shasta Lake CA 96019-9398 | 530-605-4373 | 106H00000X | 1437550498 |
Campbell, Mr. Tracy Daniel CAS | 5010 Shasta Dam Blvd Shasta Lake CA 96019-9406 | 530-275-1076 | 101YA0400X | 1861753493 |
Cates, Jeri Rene'e RN, MSN, FNPC | 5145 Shasta Dam Blvd Shasta Lake CA 96019-9403 | 530-275-5421 | 363L00000X | 1972831519 |
OTHER CA NP LISCENSE : NP 19231 |
Chambers, Dr. Ronald G I M.D. | 4174 Ashby Ct Shasta Lake CA 96019-9215 | 530-275-3094 | 207Q00000X | 1215920319 |
OTHER CA 00G271700 : BLUE CROSS || OTHER CA 00G271700 : BLUE SHIELD || OTHER CA DEA NUMBER : AC6150370 || OTHER MEDICARE ID : ZZZ01370Z || OTHER CA CALIF STATE LICENSE NUMBE : G27170 || OTHER CA VITERA ACCOUNT : 1243370356 || MEDICAID CA : 1861616567 || OTHER CA MEDI-CAL PIN NUMBER : 4490118 || OTHER CA BLUE SHIELD ID NUMBER : 00G271700 || MEDICAID CA : 00G271700 |
Codianne, Dr. Natalie PHARMD | 5350 Shasta Dam Blvd Shasta Lake CA 96019-9402 | 530-275-1532 | 183500000X | 1740561877 |
Corpuz, Terri Anne PHARM D | 5350 Shasta Dam Blvd Shasta Lake CA 96019-9402 | 530-275-1532 | 183500000X | 1932691227 |
Corral, Lisa Marie | 5034 Kevin Ln Shasta Lake CA 96019-9741 | 530-209-1837 | 183700000X | 1316389067 |
Davids, Stephen | 5061 Shasta Dam Blvd Shasta Lake CA 96019-9405 | 530-275-0777 | 225100000X | 1144839366 |
Deforest, Peggy Jane P.A. | 5145 Shasta Dam Blvd Shasta Lake CA 96019-9403 | 530-275-5421 | 363A00000X | 1447460522 |
Dilts-waldrop, Denise | 4626 Shasta Dam Blvd Shasta Lake CA 96019-9414 | (53-0) -275-0866 | 156FX1800X | 1851812267 |
Dinubilo, Lisa Marie PHARM. D | 5350 Shasta Dam Blvd Shasta Lake CA 96019-9402 | 530-275-1532 | 183500000X | 1497908552 |
Earle, Mr. James G M.P.T., C.S.C.S. | 5061 Shasta Dam Blvd Shasta Lake CA 96019-9405 | 530-275-0777 | 225100000X | 1235210501 |
MEDICAID CA : PT0184300 |
Enzler, Samantha | 5350 Shasta Dam Blvd Shasta Lake CA 96019-9402 | 530-275-1532 | 183500000X | 1063819696 |
Ferguson, Darrin RN | 17764 Pine Ave. Shasta Lake CA 96089-5793 | 530-275-4328 | 163W00000X | 1376968354 |
Hoang, Thinh Tan PHARM.D | 5350 Shasta Dam Blvd Shasta Lake CA 96019-9402 | 530-275-1532 | 183500000X | 1205129822 |
Huynh, Bao Ying RPH | 5350 Shasta Dam Blvd Shasta Lake CA 96019-9402 | 530-275-1532 | 183500000X | 1518355809 |
Ji, Zhibin DDS | 4340 Shasta Dam Blvd Shasta Lake CA 96019-9420 | 530-275-2910 | 122300000X | 1245390079 |
Knedel, Jeremy Wade P.T. | 5061 Shasta Dam Blvd Shasta Lake CA 96019-9405 | 530-275-0777 | 225100000X | 1538405881 |
Knickerbocker, Dr. .pamela Rose D.O. | 4215 Front St Shasta Lake CA 96019-9430 | 530-246-5896 | 207Q00000X | 1164561353 |
MEDICAID OK : 200182150A |
Kobe, Christopher Lewis D.C. | 4221 Shasta Dam Blvd Shasta Lake CA 96019-9423 | 530-275-1585 | 111N00000X | 1912931197 |
OTHER CA GROUP NPI : 1235152364 || OTHER CA PARTNER KAY KOBE DC NPI : 1568496743 || MEDICAID CA : DC0164540 || OTHER CA BLUE SHIELD/CROSS GROUP# : ZZZ08124Z || OTHER CA GROUP MEDICARE : ZZZ27906Z |
Kobe, Kay Ellen D.C. | 4221 Shasta Dam Blvd Shasta Lake CA 96019-9423 | 530-275-1585 | 111N00000X | 1568496743 |
OTHER PARTNERCHRIS KOBE, DC NPI : 1912931197 || OTHER CA GROUP NPI : 1235152364 || OTHER CA BLUE SHIELD/CROSS GROUP : ZZZ08124Z || MEDICAID CA : DC0174570 || OTHER CA GROUP MEDICARE : ZZZ27906Z |
Koekemoer, Mr. Pieter Jacobus RPH | 5350 Shasta Dam Blvd Shasta Lake CA 96019-9402 | 530-275-1532 | 183500000X | 1154630705 |
Marshall, Ms. Jill M LCSW | 4052 Pembroke Ln Shasta Lake CA 96019-2411 | 510-207-3557 | 1041C0700X | 1033385562 |
Martin, Dr. Richard Arthur O.D. | 4626 Shasta Dam Blvd Shasta Lake CA 96019-9414 | 530-275-0866 | 152WL0500X | 1760458269 |
Meyer, John PHARMD | 5350 Shasta Dam Blvd Shasta Lake CA 96019-9402 | 530-275-1532 | 183500000X | 1093353765 |
Moore, Dr. Adrian Glen D.C. | 4763 Vallecito St Shasta Lake CA 96019-9348 | 530-275-2422 | 111N00000X | 1235201799 |
Nuss, Mrs. Kathryn Jocelyn CASII, NCACI | 5010 Shasta Dam Blvd Shasta Lake CA 96019-9406 | 530-275-1076 | 101YA0400X | 1730449620 |
O'learly, Mr. Patrick MFT | 17682 Yellow Pine Ave Shasta Lake CA 96019-2074 | 530-275-6006 | 106H00000X | 1538209572 |
Porter, Elaine MD | 4215 Front St Shasta Lake CA 96019-9430 | 530-246-5710 | 207Q00000X | 1972522613 |
Ratliff, Jennifer Lynn PT | 4216 Shasta Dam Blvd Shasta Lake CA 96019-9422 | 530-275-0777 | 225100000X | 1083809750 |
Russell, Mr. John Douglas DDS | 4178 Ashby Court Shasta Lake City CA 96019 | 530-275-2910 | 122300000X | 1902958077 |
MEDICAID CA : B2004201 |
Smith, Ms. Pamela Jeanne CAS | 5010 Shasta Dam Blvd Shasta Lake CA 96019-9406 | 530-275-1076 | 101YA0400X | 1457612087 |
Troll, Ryan Vaughn DPT | 5061 Shasta Dam Blvd Shasta Lake CA 96019-9405 | 530-275-0777 | 225100000X | 1477008035 |
Waldrop, Mr. Gary Daniel OPTICIAN | 4601 Shasta Dam Blvd Shasta Lake CA 96019-9413 | 530-275-8581 | 156FX1800X | 1861516007 |
OTHER CA MEDICAL EYE SERVICES : 9419 || OTHER CA EYE MED PROVIDER NUMBER : CA4661 || MEDICAID CA : DX067260F |
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