| Warner Mountain Indian Health Project | |
|
132 Mee Thee Uh Road Fort Bidwell CA 96112 | |
| (530) 279-6194 | |
| (530) 279-6288 |
| Full Name | Warner Mountain Indian Health Project |
|---|---|
| Speciality | Clinic/Center |
| Location | 132 Mee Thee Uh Road, Fort Bidwell, California |
| Authorized Official Name and Position | Candice Dawn Russell (CLINIC MANAGER) |
| Authorized Official Contact | 5302796194 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Warner Mountain Indian Health Project Po Box 247 Fort Bidwell CA 96112-0247 Ph: (530) 279-6194 | Warner Mountain Indian Health Project 132 Mee Thee Uh Road Fort Bidwell CA 96112 Ph: (530) 279-6194 |
| NPI Number | 1093931107 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 07/02/2008 |
| Medicare PECOS PAC ID | 5890960355 |
|---|---|
| Medicare Enrollment ID | O20111212000333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093931107 | NPI | - | NPPES |
| THP70973F | Medicaid | CA | |
| O5D0692143 | Other | CA | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Donna Schindler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235203597 PECOS PAC ID: 2961393426 Enrollment ID: I20170525001195 |
| Provider Name | Danielle Anne Eigner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801989280 PECOS PAC ID: 9133290539 Enrollment ID: I20180423000031 |
| Provider Name | Constance A Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477600195 PECOS PAC ID: 9739288515 Enrollment ID: I20180522000198 |
| Provider Name | Divya Krishnamoorthy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194742825 PECOS PAC ID: 9830192871 Enrollment ID: I20180522000365 |
| Provider Name | Robert D Frey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912934779 PECOS PAC ID: 0345250619 Enrollment ID: I20180522000757 |
| Provider Name | Gary Haffner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407950710 PECOS PAC ID: 3476551565 Enrollment ID: I20181129000705 |
| Provider Name | Patricia Chico |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801162565 PECOS PAC ID: 2567782808 Enrollment ID: I20231227000178 |