Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shasta Community Health Center

Organization Dentist · NPI 1013932797

Shasta Community Health Center is a Dentist in Shasta Lake, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
Specialties on file
5

Practice location Address checks out

4215 Frnt ST
Shasta Lake, CA 96019-9430
Phone: (530) 246-5896
Fax: (530) 241-7838
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Federally Qualified Health Center (FQHC) (primary) Taxonomy 261QF0400X
Dentist Taxonomy 122300000X · Licence 230000325 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 230000325 (CA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 230000325 (CA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 230000325 (CA)

Record details

NPI number1013932797
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationShasta Community Health Center
Authorized official Jeffery Thornock — Ceo · (530) 246-5074
Other names Shasta Lake Family Health & Dental Center
NPI enumeratedJuly 13, 2006
Last updated in NPPESOctober 16, 2024
Certification dateOctober 16, 2024
Mailing addressPo Box 992790, Redding, CA 96099-2790

Other providers in Shasta Lake