| Redding Rancheria | |
|
1441 Liberty St Redding CA 96001-0811 | |
| (530) 226-1753 | |
| (530) 224-2723 |
| Full Name | Redding Rancheria |
|---|---|
| Speciality | Clinic/Center |
| Location | 1441 Liberty St, Redding, California |
| Authorized Official Name and Position | Lori Hernandez (BILLING MANAGER) |
| Authorized Official Contact | 5302261740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Redding Rancheria 1441 Liberty St Redding CA 96001-0848 Ph: (530) 226-1753 | Redding Rancheria 1441 Liberty St Redding CA 96001-0811 Ph: (530) 226-1753 |
| NPI Number | 1104859354 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 09/21/2021 |
| Medicare PECOS PAC ID | 7810969847 |
|---|---|
| Medicare Enrollment ID | O20040810001377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104859354 | NPI | - | NPPES |
| HAP70489F | Medicaid | CA | |
| THP70489F | Medicaid | CA | |
| BCP70489F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 20A7013 (California) | Primary |
| Provider Name | Carlota Cruz Nepomuceno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316067622 PECOS PAC ID: 2062308430 Enrollment ID: I20040225000258 |
| Provider Name | Paul J Scipione |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609266071 PECOS PAC ID: 0143293746 Enrollment ID: I20040812001475 |
| Provider Name | Joanna K Ramseyer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588778815 PECOS PAC ID: 6608775713 Enrollment ID: I20041112000870 |
| Provider Name | Nelson G Madrilejo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023110103 PECOS PAC ID: 9739145426 Enrollment ID: I20041203000989 |
| Provider Name | Jay S Roitman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366461220 PECOS PAC ID: 1052363900 Enrollment ID: I20050218000441 |
| Provider Name | Jolene Angel Kingsley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639195837 PECOS PAC ID: 7810944600 Enrollment ID: I20050404000967 |
| Provider Name | Michael C Kingsley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427078393 PECOS PAC ID: 0446207252 Enrollment ID: I20050404001161 |
| Provider Name | Mitchell Lynn Hawley |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659452399 PECOS PAC ID: 2466490776 Enrollment ID: I20050418001242 |
| Provider Name | Joe Villalobos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770502445 PECOS PAC ID: 1355389172 Enrollment ID: I20050421001378 |
| Provider Name | Mohamed H Khan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1649230988 PECOS PAC ID: 9436130846 Enrollment ID: I20050428000462 |
| Provider Name | Norman M Verhoog |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558388066 PECOS PAC ID: 1658314687 Enrollment ID: I20050609000834 |
| Provider Name | Christina Cosh-davis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811980493 PECOS PAC ID: 0941220891 Enrollment ID: I20051206001033 |
| Provider Name | Kelly Hering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124131883 PECOS PAC ID: 3779582325 Enrollment ID: I20061209000092 |
| Provider Name | Leonard J Soloniuk |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356353247 PECOS PAC ID: 4385611946 Enrollment ID: I20070921000462 |
| Provider Name | John D Egolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891991923 PECOS PAC ID: 7810087798 Enrollment ID: I20071214000676 |
| Provider Name | Mindy L Crookham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467645382 PECOS PAC ID: 3779673363 Enrollment ID: I20071219000695 |
| Provider Name | Neil A Louwrens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174621320 PECOS PAC ID: 0446329726 Enrollment ID: I20080513000795 |
| Provider Name | Paul R Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609989532 PECOS PAC ID: 9234175498 Enrollment ID: I20091014000790 |
| Provider Name | Sahaile Ann Kristoffersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265443972 PECOS PAC ID: 9638294960 Enrollment ID: I20100910000019 |
| Provider Name | Shyam A Kumbhani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124256904 PECOS PAC ID: 9133397367 Enrollment ID: I20110714000267 |
| Provider Name | James R Bennie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023271871 PECOS PAC ID: 1254509094 Enrollment ID: I20110721000122 |
| Provider Name | Gretchen J Melburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790066686 PECOS PAC ID: 9335316496 Enrollment ID: I20120113000128 |
| Provider Name | Kathryn Lee Rehberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023151065 PECOS PAC ID: 8325285646 Enrollment ID: I20130506000168 |
| Provider Name | Melinda J Orellana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306150446 PECOS PAC ID: 6305073909 Enrollment ID: I20131205000492 |
| Provider Name | Gavin Moloney |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1194063149 PECOS PAC ID: 6800024845 Enrollment ID: I20140120000607 |
| Provider Name | Jessica D Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497888622 PECOS PAC ID: 6709004518 Enrollment ID: I20140820000198 |
| Provider Name | Mark Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376981845 PECOS PAC ID: 5991018178 Enrollment ID: I20150716002099 |
| Provider Name | Patricia Denise Lind |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992932065 PECOS PAC ID: 5193026201 Enrollment ID: I20151215001006 |
| Provider Name | Megan R Fenyoe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972725505 PECOS PAC ID: 9830479575 Enrollment ID: I20161214002548 |
| Provider Name | Michael Paul Hansen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457893802 PECOS PAC ID: 6002197399 Enrollment ID: I20161228000930 |
| Provider Name | Katherine Marie Hudson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326403502 PECOS PAC ID: 5890071716 Enrollment ID: I20170407001019 |
| Provider Name | Tara Mckittrick Braemer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255877957 PECOS PAC ID: 6002184785 Enrollment ID: I20170621002338 |
| Provider Name | Allison M Tims |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831445949 PECOS PAC ID: 6002125069 Enrollment ID: I20171017002925 |
| Provider Name | Kara Anne Carmona Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699291591 PECOS PAC ID: 0749540649 Enrollment ID: I20180215000387 |
| Provider Name | Jennifer A Woolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528573227 PECOS PAC ID: 6406103712 Enrollment ID: I20180718001129 |
| Provider Name | Jonie K Wade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194234104 PECOS PAC ID: 7315294923 Enrollment ID: I20180726003207 |
| Provider Name | Angelique Michelle Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184768863 PECOS PAC ID: 9830442334 Enrollment ID: I20181031000766 |
| Provider Name | Brandon L Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780977280 PECOS PAC ID: 4688909195 Enrollment ID: I20190703002869 |
| Provider Name | Michelle Drobny |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124432505 PECOS PAC ID: 4789979451 Enrollment ID: I20190912002382 |
| Provider Name | Matthew John Grana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750739934 PECOS PAC ID: 4880920446 Enrollment ID: I20191227002112 |
| Provider Name | Jennifer Harmon Boudreaux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275179012 PECOS PAC ID: 0345675922 Enrollment ID: I20200109001182 |
| Provider Name | Nicole Anne Cassedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982183760 PECOS PAC ID: 1557799939 Enrollment ID: I20200318000695 |
| Provider Name | Rachel Chavez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932517455 PECOS PAC ID: 5597195925 Enrollment ID: I20200429001649 |
| Provider Name | Misty L Barnett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134358211 PECOS PAC ID: 0749608834 Enrollment ID: I20200922003167 |
| Provider Name | Jessica Denise Sutton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992241707 PECOS PAC ID: 1052722212 Enrollment ID: I20201119003155 |
| Provider Name | Vanessa A Scholfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487012936 PECOS PAC ID: 3779995568 Enrollment ID: I20201221000660 |
| Provider Name | Jessica L Hermann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821573049 PECOS PAC ID: 1153738521 Enrollment ID: I20210331001737 |
| Provider Name | Glen Ruel Hayward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417522145 PECOS PAC ID: 7214202225 Enrollment ID: I20210806002538 |
| Provider Name | Amber X Li |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245845700 PECOS PAC ID: 8527472729 Enrollment ID: I20210827002584 |
| Provider Name | Faith Christine Clause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093250862 PECOS PAC ID: 8628355526 Enrollment ID: I20220322001145 |
| Provider Name | Sara Leona Nopwaskey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871102228 PECOS PAC ID: 6103200076 Enrollment ID: I20220826002711 |
| Provider Name | Stephanie Ann Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780854760 PECOS PAC ID: 3274918008 Enrollment ID: I20220915001048 |
| Provider Name | Serena Goldsmith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962758615 PECOS PAC ID: 6901278498 Enrollment ID: I20230209001518 |
| Provider Name | Aishwarya Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063049476 PECOS PAC ID: 1759703721 Enrollment ID: I20230727002629 |
| Provider Name | Cheree Nichole Van Eyck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154027001 PECOS PAC ID: 4880056605 Enrollment ID: I20230810003353 |
| Provider Name | Safa Hammami |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1679006811 PECOS PAC ID: 8921421728 Enrollment ID: I20231116002113 |
| Provider Name | Jiraporn Dow Angspatt |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1992945489 PECOS PAC ID: 2668824889 Enrollment ID: I20240123003325 |
| Provider Name | Christina Rose Newton |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1144552688 PECOS PAC ID: 9830542653 Enrollment ID: I20240129002233 |
| Provider Name | Norma Ellenwood |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356726756 PECOS PAC ID: 6507219235 Enrollment ID: I20240130001711 |
| Provider Name | Cheryl Stewart |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1457778052 PECOS PAC ID: 4688027287 Enrollment ID: I20240131000760 |
| Provider Name | Clyde Eugene Tibbett |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1235663006 PECOS PAC ID: 6901249994 Enrollment ID: I20240206004935 |
| Provider Name | Sara Hurn |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1750807731 PECOS PAC ID: 7315380235 Enrollment ID: I20240208000009 |
| Provider Name | Alexandra R Rusu |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1770009102 PECOS PAC ID: 2466891650 Enrollment ID: I20240422000300 |
| Provider Name | Regan Marie Steil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992353866 PECOS PAC ID: 3476994443 Enrollment ID: I20240509000070 |
Andrew L Knapp Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 Butte St, Redding, CA 96001 Phone: 530-243-0498 | |
Than T Aung Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2421 Old Eureka Way, Redding, CA 96001 Phone: 530-225-8775 Fax: 530-225-8778 | |
Shasta Community College - Student Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11555 Old Oregon Trl, Redding, CA 96003 Phone: 530-242-7580 Fax: 530-225-4968 | |
Excellence In Healthcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2110 Railroad Ave., Redding, CA 96001 Phone: 530-243-1414 Fax: 530-243-0493 | |
Prestige Urgent Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 85 Hartnell Ave, Redding, CA 96002 Phone: 530-262-6001 | |
Docs Medical Group Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2510 Airpark Dr, Suite 102, Redding, CA 96001 Phone: 530-243-8667 Fax: 530-243-8742 | |
Mercy Maternity Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1900 Railroad Ave, Redding, CA 96001 Phone: 530-225-7486 Fax: 530-225-7293 |