| Karuk Tribal Health Program | |
|
1519 S Oregon St Yreka CA 96097-3425 | |
| (530) 842-9200 | |
| (530) 842-9207 |
| Full Name | Karuk Tribal Health Program |
|---|---|
| Speciality | General Practice |
| Location | 1519 S Oregon St, Yreka, California |
| Authorized Official Name and Position | Russell Attebery (TRIBAL CHAIRMAN) |
| Authorized Official Contact | 5304931600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Karuk Tribal Health Program Po Box 1016 Happy Camp CA 96039-1016 Ph: (530) 493-1600 | Karuk Tribal Health Program 1519 S Oregon St Yreka CA 96097-3425 Ph: (530) 842-9200 |
| NPI Number | 1730279423 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 02/08/2017 |
| Medicare PECOS PAC ID | 4688668387 |
|---|---|
| Medicare Enrollment ID | O20040414000866 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730279423 | NPI | - | NPPES |
| 1730279423 | Medicaid | CA | |
| ZZZ16552Z | Other | CA | BLUE SHIELD OF CALIFORNIA |
| 1730279423 | Other | CA | MEDICARE |
| Provider Name | Amy M Coapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700804614 PECOS PAC ID: 3173517711 Enrollment ID: I20040414001209 |
| Provider Name | Tony E Vasquez |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1477524197 PECOS PAC ID: 5395824643 Enrollment ID: I20080512000384 |
| Provider Name | Thomas J Andrews |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245393651 PECOS PAC ID: 7618015983 Enrollment ID: I20091130000432 |
| Provider Name | Patricia Hobbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760604029 PECOS PAC ID: 1153510391 Enrollment ID: I20130131000337 |
| Provider Name | Thomas Mani Kurian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356675573 PECOS PAC ID: 8426296195 Enrollment ID: I20141125000470 |
| Provider Name | Marlis L Langi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710933767 PECOS PAC ID: 3577506419 Enrollment ID: I20150422001018 |
| Provider Name | Sarah D Thibault |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134452980 PECOS PAC ID: 8628383361 Enrollment ID: I20150810003211 |
| Provider Name | Aditi B Bhaduri |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1114029329 PECOS PAC ID: 2668417569 Enrollment ID: I20151013001026 |
| Provider Name | Peggy Einsele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194185397 PECOS PAC ID: 0941599500 Enrollment ID: I20160520001120 |
| Provider Name | Diana Moser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154329555 PECOS PAC ID: 2769475623 Enrollment ID: I20180328001431 |
| Provider Name | Joseph E Snapp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245736099 PECOS PAC ID: 8123382173 Enrollment ID: I20180430000326 |
| Provider Name | Melissa S Butts |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1790945756 PECOS PAC ID: 6608170386 Enrollment ID: I20180628002790 |
| Provider Name | Claudia R Mondragon |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1386938256 PECOS PAC ID: 5799020061 Enrollment ID: I20181214002785 |
| Provider Name | Jessica L Paredes |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1043623168 PECOS PAC ID: 3274968821 Enrollment ID: I20200109000291 |
| Provider Name | Julie A Gaulden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356045462 PECOS PAC ID: 3678931227 Enrollment ID: I20230614001881 |
| Provider Name | David F Arwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457728982 PECOS PAC ID: 6406292382 Enrollment ID: I20240313004350 |
| Provider Name | Joy E Tennant |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104014356 PECOS PAC ID: 6507202652 Enrollment ID: I20240509003108 |
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