| North State Swaps | |
|
1135 Pine St Ste 21 Redding CA 96001-0750 | |
| (530) 638-2067 | |
| (949) 561-5392 |
| Full Name | North State Swaps |
|---|---|
| Speciality | Social Worker |
| Location | 1135 Pine St Ste 21, Redding, California |
| Authorized Official Name and Position | Jantina Thompson (CEO / PRESIDENT) |
| Authorized Official Contact | 5306382067 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North State Swaps 859 Washington St # 203 Red Bluff CA 96080-2704 Ph: (530) 638-2067 | North State Swaps 1135 Pine St Ste 21 Redding CA 96001-0750 Ph: (530) 638-2067 |
| NPI Number | 1851969059 |
|---|---|
| Provider Enumeration Date | 06/14/2021 |
| Last Update Date | 07/21/2021 |
| Certification Date | 07/21/2021 |
| Medicare PECOS PAC ID | 0143622399 |
|---|---|
| Medicare Enrollment ID | O20210709001413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851969059 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Jantina Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104242767 PECOS PAC ID: 8921427113 Enrollment ID: I20201008000907 |
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