SHASTA LAKE FAMILY HEALTH & DENTAL CENTER
NPI 1013932797
Clinic/Center - Federally Qualified Health Center (FQHC) in Shasta Lake, CA

Q: What is Shasta Community Health Center's NPI number?

The NPI number for Shasta Community Health Center is 1013932797. It was assigned to this organization in the NPPES registry on July 13, 2006. The provider is doing business as Shasta Lake Family Health & Dental Center.

Q: What is Shasta Community Health Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since July 13, 2006

4215 FRONT ST, SHASTA LAKE, CA 96019(530) 246-5896(530) 241-7838 Get Directions Write a Review

NPPES record last updated: October 16, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Shasta Lake Family Health & Dental Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHASTA LAKE FAMILY HEALTH & DENTAL CENTER (NPI 1013932797) is a healthcare organization registered as a federally qualified health center (fqhc) in Shasta Lake, California and active in the NPI registry since July 2006. The organization lists Jeffery Brandon Thornock, Ceo, as its authorized official.

NPPES Registry Identity

NPI1013932797

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameSHASTA COMMUNITY HEALTH CENTER

Location Address4215 FRONT STShasta Lake, CA 96019-9430

Mailing AddressPo Box 992790Redding, CA 96099-2790 · (530) 246-5896 · Fax (530) 241-7836

Phone(530) 246-5896

Fax(530) 241-7838

Organization SubpartYes

Authorized OfficialJeffery Brandon ThornockCeo · (530) 246-5074

Enumeration DateJuly 13, 2006

Last NPPES UpdateOctober 16, 2024

NPPES CertifiedOctober 16, 2024

✔ NPI 1013932797 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedDentistTaxonomy 122300000X · License 230000325 (CA)

Also ListedFamily MedicineTaxonomy 207Q00000X · License 230000325 (CA)

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 230000325 (CA)

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 230000325 (CA)

4215 FRONT ST, Shasta Lake, CA 96019

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Other Names 1

Doing Business AsShasta Lake Family Health & Dental Center

Other Identifiers 1

OtherFHC70877FCA · Schc-slc Medi-cal Number

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LIMS SHASTA LAKE PHARMACY INC

Pharmacy (Community/Retail Pharmacy)

4215 FRONT ST, STE 31
SHASTA LAKE, CA 96019

Shasta County (530) 275-2100

LYNN PAINTER RDH

Dental Hygienist

4215 FRONT ST
SHASTA LAKE, CA 96019

Shasta County (530) 276-9129

MRS. MELODIE G. GILL FNP

Nurse Practitioner (Family)

4215 FRONT ST
SHASTA LAKE, CA 96019

Shasta County (530) 276-9168

ELAINE PORTER MD

Family Medicine

4215 FRONT ST
SHASTA LAKE, CA 96019

Shasta County (530) 246-5710

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shasta Community Health Center's NPI number?

The NPI number for Shasta Community Health Center is 1013932797. It was assigned to this organization in the NPPES registry on July 13, 2006. The provider is doing business as Shasta Lake Family Health & Dental Center.

Where is Shasta Community Health Center located?

Shasta Community Health Center is located at 4215 Front St, Shasta Lake, CA 96019. The listed phone number is (530) 246-5896.

What is Shasta Community Health Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Shasta Community Health Center was last updated on October 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.