Provider Demographics
NPI:1962796268
Name:PLANNED PARENTHOOD SHASTA DIABLO, INC
Entity type:Organization
Organization Name:PLANNED PARENTHOOD SHASTA DIABLO, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCESS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-887-5369
Mailing Address - Street 1:2185 PACHECO ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2309
Mailing Address - Country:US
Mailing Address - Phone:925-676-0505
Mailing Address - Fax:
Practice Address - Street 1:242 HOSPITAL DR STE A
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4556
Practice Address - Country:US
Practice Address - Phone:707-462-4303
Practice Address - Fax:707-462-4490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical