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Medi-Cal Provider Directory Shasta County CONTACT US (800) 863-4155 | http://www.partnershiphp.org Revised Date: May 25, 2018 08-85215_CPL_001 04/18/2013

Shasta County Medi-Cal Provider Directorypartnershiphp.org/Providers/Medi-Cal/Documents/Provider Directory... · Page 1 of 39 PHC PROVIDERS | SHASTA COUNTY DIRECTORY To verify the

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Medi-Cal Provider DirectoryShasta County

CONTACT US

(800) 863-4155 | httpwwwpartnershiphporg

Revised Date May 25 2018

08-85215_CPL_001 04182013

Page i of i

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

TABLE OF CONTENTS

How to use this list 1Para usar esta lista 2Glossary of Terms 3Glosario de teacuterminos 5Nondiscrimination Notice 7Aviso de no discriminacioacuten 9Grievances 8Quejas 10Language Assistance 11Asistencia de idiomas 11Accessibility Standards 14Estaacutendares de Accesibilidad 15Timely Access to Care 16Acceso oportuno a la atencioacuten meacutedica 17Physician Listing Information 18Informacioacuten del listado de meacutedicos 18Shasta Primary Care Provider 19

Anderson 19Burney 20Cottonwood 21Fall River Mills 22Palo Cedro 22Red Bluff 23Redding 24Round Mountain 29Shasta Lake 29Shingletown 30

Shasta Facilities Pharmacy Urgent Care amp VSP List 31Hospitals Primary 31Hospitals Referral 31Mental Health Services - Outpatient 33Pharmacy Network List 33Skilled Nursing Long Term Care Facilities 36Urgent Care Sites 37Vision Service Plan (VSP) (1-800-877-7195) 38

INDEX 40

Page 1 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

How to use this list

1 Pick two primary care providers (PCPs) One will be your first choice and the other will be your second choice Weask you to pick a second choice in case your first choice is not available

2 Write the names and the provider numbers of the primary care providers that you picked on the enclosed PrimaryCare Provider Selection Form Call our Members Services Department to make sure the doctor or medical group isavailable

3 Return the Primary Care Selection Form to PHC using the enclosed postage paid return envelope

4 You can access some Medi-Cal benefits without an authorization from your PCP Please refer to your MemberHandbook or call the PHC Member Services Department for more information about these services

5 Some hospitals andor primary care providers may not provide one or more of the following services that arecovered benefits family planning contraceptive services including emergency contraception sterilization includingtubal ligation or abortion You can obtain more information about these services before you choose your PCP bycalling your prospective primary care provider or by calling the PHCrsquos Member Services Department at(800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711

6 Members are encouraged to pick a Primary Care Provider (PCP) that is closest to their home However memberscan choose any PCP in their County that is available in this Provider Directory

7 The telephone number listed under each site in this directory is the same number to call after normal businesshours

If you need help filling out the Primary Care Selection Form or if you have any questions about choosing a primary care provider please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711

Your PCP will give you a referral to send you to a specialist if you need one A specialist is a doctor who has extra education in one area of medicine Your PCP will work with you to choose a specialist

For some types of care your PCP or specialist will need to ask for approval before you get the care This is called prior authorization or pre-approval It means that PHC agrees that the care is medically necessary

If you have any questions concerning handicapped accessibility please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711

Page 2 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Para usar esta lista

1 Escoja dos proveedores de atencioacuten primaria (PCP) El primero seraacute el meacutedico que usted prefiere y el segundoseraacute el que prefiere en segundo lugar Le pedimos que seleccione dos en caso que el doctor que prefiere no esteacutedisponible

2 Escriba los nombres y el nuacutemero de proveedor de cada uno de los dos meacutedicos que escogioacute en el formulario quese llama Primary Care Provider Selection Form Llame a Nuestro Departamento de Servicio al Miembro paraasegurarse de que el doctor o el grupo medico estaacute disponible

3 Regrese el formulario por correo a PHC en el sobre con sello que le incluimos

4 Usted puede recibir algunos beneficios de Medi-Cal sin ninguna autorizacioacuten de su doctor primario Por favor dereferir a su Manual para Miembros o llame al departamento de servicios para miembro de PHC para maacutesinformacioacuten sobre estos servicios

5 Algunos hospitales o proveedores de atencioacuten primaria puede que no ofrezcan uno o maacutes de los siguientesbeneficios que estaacuten cubiertos como planificacioacuten familiar servicios anticonceptivos incluyendo anticonceptivo deemergencia esterilizacioacuten incluyendo ligadura de las trompas o aborto Usted puede recibir maacutes informacioacuten deestos servicios antes de escoger a su PCP si llama a su prospectivo proveedor de atencioacuten primaria o si llama alDepartamento de Servicios para Miembros de PHC al (800) 863-4155 (TTY (800) 735-2929 or 711)

6 Animados a miembros a escoger el proveedor primario (PCP) que esteacute maacutes cerca de su casa Sin embargomiembros pueden escoger cualquier PCP en su condado que esteacute disponible en este Directorio de Proveedores

7 El nuacutemero de teleacutefono enumerado debajo de cada sitio en el directorio es el mismo nuacutemero para llamar despueacutes dehoras normales del negocio

Si necesita ayuda para completar el formulario que se llama Primary Care Provider Selection Form o si tiene preguntas sobre coacutemo escoger un proveedor de atencioacuten primaria por favor llame a nuestro Departamento de Servicios para Miembros al (800) 863-4155 (TTY (800) 735-2929 or 711)

Su PCP le daraacute una referencia para enviarlo a un especialista si lo necesita Un especialista es un meacutedico que tiene educacioacuten adicional en un aacuterea de la medicina Su PCP trabajaraacute con usted para elegir un especialista

Para algunos tipos de cuidado su PCP o especialista necesitaraacute pedir autorizacioacuten antes de que usted obtenga la atencioacuten meacutedica Esto se llama autorizacioacuten o aprobacioacuten previa Esto significa que PHC esteacute de acuerdo en que el cuidado es meacutedicamente necesario

Si tiene cualquier pregunta sobre acceso para incapacitados por favor llame al Departamento de Servicios para Miembros al ((800) 863-4155 (TTY (800) 735-2929 or 711)

Page 3 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC Provider Directory - Glossary of Terms

Here youll find definitions of basic terms used in the PHC Provider Directory If you are unable to

find an answer to your question please call Member Services at

(800) 863-4155

Accreditation

When a hospital goes through a review to assess the quality of its systems and processes by an outside organization

Ancillary Provider

An ancillary provider includes durable medical equipment provider physical therapist occupational therapist etc

Board Certification

Board certification means the physician completed additional education and training in an area of medicine and passed an examination that certifies he or she has expertise in this area

Community Health Clinic

This is a clinic staffed by a group of doctors and nurses located in a community

Medical Group Affiliations

The practice or medical group the provider belongs to

Assigned Hospital

The hospital that your provider will send you to when you need care unless the care is not available at this hospital

Provider Languages

Languages spoken by provider Additionally other languages may be spoken by office and clinical staff These additional languages are included as part of the provider specific information

Provider Address

The location where services and care are rendered

Provider Site Status

Accepting New Patients The provider site is able to see new patients

Accepting New Patients The provider site is only able to see patients who are alreadyassigned to the site

Available by Referral Only The provider site is only able to see patients who are referredby their primary care physician

Page 4 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility

Not Accepting New Patients The provider site is not able to add new patients to their site

Specialty Type

Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital

Wheelchair amp Accessibility Codes

This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms

Levels of Access

Accessibility Codes (see page 13 for a description of codesP EB IB R E T )

Basic Access

The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)

Limited Access

The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T

Medical Equipment Access

The office meets the standard below for exam tables and scales (T)

Page 5 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Directorio de proveedores de PHC - Glosario de teacuterminos

Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de

PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al

(800) 863-4155

Acreditacioacuten

Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa

Proveedores auxiliares

Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc

Certificacioacuten de la Junta

Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea

Cliacutenica de salud de la comunidad

Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad

Afiliaciones de grupo meacutedico

El consultorio o grupo meacutedico al que pertenece el proveedor

Hospital Asignado

El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital

Idiomas del proveedor

Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor

Direccioacuten del proveedor

El lugar donde se prestan los servicios y la atencioacuten

Estado del sitio del proveedor

Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos

Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio

Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a

Page 6 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

pacientes que son referidos por su meacutedico de atencioacuten primaria

Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro

No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio

Tipo de especialidad

Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital

Sillas de ruedas y coacutedigos de accesibilidad

Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos

Niveles de acceso

Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )

Acceso baacutesico

El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)

Acceso limitado

El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T

Acceso de equipo meacutedico

El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)

Page 7 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

NONDISCRIMINATION NOTICE

Discrimination is against the law Partnership HealthPlan of California follows

Federal civil rights laws Partnership HealthPlan of California does not

discriminate exclude people or treat them differently because of race color

national origin age disability or sex

Partnership HealthPlan of California provides

Free aids and services to people with disabilities to help them communicate

better such as

Qualified sign language interpreters

Written information in other formats (large print audio accessible

electronic formats other formats)

Free language services to people whose primary language is not English

such as

Qualified interpreters

Information written in other languages

If you need these services contact Partnership HealthPlan of California between

8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well

please call (800) 735-2929 or 711

Page 8 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

HOW TO FILE A GRIEVANCE

If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another

way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan

of California You can file a grievance by phone in writing in person or electronically

bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or

if you cannot hear or speak well please call (800) 735-2929 or 711

bull In writing Fill out a complaint form or write a letter and send it to

Partnership HealthPlan of California

4665 Business Center Drive

Fairfield CA 94534

OR

Partnership HealthPlan of California

3688 Avtech Parkway

Redding CA 96002

bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance

bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg

OFFICE OF CIVIL RIGHTS

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights

by phone in writing or electronically

bull By phone Call (800) 368-1019 If you cannot speak or hear well please call

TTYTDD (800) 537-7697

bull In writing Fill out a complaint form or send a letter to

US Department of Health and Human Services

200 Independence Avenue SW

Room 509F HHH Building

Washington DC 20201

Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml

bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page i of i

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

TABLE OF CONTENTS

How to use this list 1Para usar esta lista 2Glossary of Terms 3Glosario de teacuterminos 5Nondiscrimination Notice 7Aviso de no discriminacioacuten 9Grievances 8Quejas 10Language Assistance 11Asistencia de idiomas 11Accessibility Standards 14Estaacutendares de Accesibilidad 15Timely Access to Care 16Acceso oportuno a la atencioacuten meacutedica 17Physician Listing Information 18Informacioacuten del listado de meacutedicos 18Shasta Primary Care Provider 19

Anderson 19Burney 20Cottonwood 21Fall River Mills 22Palo Cedro 22Red Bluff 23Redding 24Round Mountain 29Shasta Lake 29Shingletown 30

Shasta Facilities Pharmacy Urgent Care amp VSP List 31Hospitals Primary 31Hospitals Referral 31Mental Health Services - Outpatient 33Pharmacy Network List 33Skilled Nursing Long Term Care Facilities 36Urgent Care Sites 37Vision Service Plan (VSP) (1-800-877-7195) 38

INDEX 40

Page 1 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

How to use this list

1 Pick two primary care providers (PCPs) One will be your first choice and the other will be your second choice Weask you to pick a second choice in case your first choice is not available

2 Write the names and the provider numbers of the primary care providers that you picked on the enclosed PrimaryCare Provider Selection Form Call our Members Services Department to make sure the doctor or medical group isavailable

3 Return the Primary Care Selection Form to PHC using the enclosed postage paid return envelope

4 You can access some Medi-Cal benefits without an authorization from your PCP Please refer to your MemberHandbook or call the PHC Member Services Department for more information about these services

5 Some hospitals andor primary care providers may not provide one or more of the following services that arecovered benefits family planning contraceptive services including emergency contraception sterilization includingtubal ligation or abortion You can obtain more information about these services before you choose your PCP bycalling your prospective primary care provider or by calling the PHCrsquos Member Services Department at(800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711

6 Members are encouraged to pick a Primary Care Provider (PCP) that is closest to their home However memberscan choose any PCP in their County that is available in this Provider Directory

7 The telephone number listed under each site in this directory is the same number to call after normal businesshours

If you need help filling out the Primary Care Selection Form or if you have any questions about choosing a primary care provider please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711

Your PCP will give you a referral to send you to a specialist if you need one A specialist is a doctor who has extra education in one area of medicine Your PCP will work with you to choose a specialist

For some types of care your PCP or specialist will need to ask for approval before you get the care This is called prior authorization or pre-approval It means that PHC agrees that the care is medically necessary

If you have any questions concerning handicapped accessibility please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711

Page 2 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Para usar esta lista

1 Escoja dos proveedores de atencioacuten primaria (PCP) El primero seraacute el meacutedico que usted prefiere y el segundoseraacute el que prefiere en segundo lugar Le pedimos que seleccione dos en caso que el doctor que prefiere no esteacutedisponible

2 Escriba los nombres y el nuacutemero de proveedor de cada uno de los dos meacutedicos que escogioacute en el formulario quese llama Primary Care Provider Selection Form Llame a Nuestro Departamento de Servicio al Miembro paraasegurarse de que el doctor o el grupo medico estaacute disponible

3 Regrese el formulario por correo a PHC en el sobre con sello que le incluimos

4 Usted puede recibir algunos beneficios de Medi-Cal sin ninguna autorizacioacuten de su doctor primario Por favor dereferir a su Manual para Miembros o llame al departamento de servicios para miembro de PHC para maacutesinformacioacuten sobre estos servicios

5 Algunos hospitales o proveedores de atencioacuten primaria puede que no ofrezcan uno o maacutes de los siguientesbeneficios que estaacuten cubiertos como planificacioacuten familiar servicios anticonceptivos incluyendo anticonceptivo deemergencia esterilizacioacuten incluyendo ligadura de las trompas o aborto Usted puede recibir maacutes informacioacuten deestos servicios antes de escoger a su PCP si llama a su prospectivo proveedor de atencioacuten primaria o si llama alDepartamento de Servicios para Miembros de PHC al (800) 863-4155 (TTY (800) 735-2929 or 711)

6 Animados a miembros a escoger el proveedor primario (PCP) que esteacute maacutes cerca de su casa Sin embargomiembros pueden escoger cualquier PCP en su condado que esteacute disponible en este Directorio de Proveedores

7 El nuacutemero de teleacutefono enumerado debajo de cada sitio en el directorio es el mismo nuacutemero para llamar despueacutes dehoras normales del negocio

Si necesita ayuda para completar el formulario que se llama Primary Care Provider Selection Form o si tiene preguntas sobre coacutemo escoger un proveedor de atencioacuten primaria por favor llame a nuestro Departamento de Servicios para Miembros al (800) 863-4155 (TTY (800) 735-2929 or 711)

Su PCP le daraacute una referencia para enviarlo a un especialista si lo necesita Un especialista es un meacutedico que tiene educacioacuten adicional en un aacuterea de la medicina Su PCP trabajaraacute con usted para elegir un especialista

Para algunos tipos de cuidado su PCP o especialista necesitaraacute pedir autorizacioacuten antes de que usted obtenga la atencioacuten meacutedica Esto se llama autorizacioacuten o aprobacioacuten previa Esto significa que PHC esteacute de acuerdo en que el cuidado es meacutedicamente necesario

Si tiene cualquier pregunta sobre acceso para incapacitados por favor llame al Departamento de Servicios para Miembros al ((800) 863-4155 (TTY (800) 735-2929 or 711)

Page 3 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC Provider Directory - Glossary of Terms

Here youll find definitions of basic terms used in the PHC Provider Directory If you are unable to

find an answer to your question please call Member Services at

(800) 863-4155

Accreditation

When a hospital goes through a review to assess the quality of its systems and processes by an outside organization

Ancillary Provider

An ancillary provider includes durable medical equipment provider physical therapist occupational therapist etc

Board Certification

Board certification means the physician completed additional education and training in an area of medicine and passed an examination that certifies he or she has expertise in this area

Community Health Clinic

This is a clinic staffed by a group of doctors and nurses located in a community

Medical Group Affiliations

The practice or medical group the provider belongs to

Assigned Hospital

The hospital that your provider will send you to when you need care unless the care is not available at this hospital

Provider Languages

Languages spoken by provider Additionally other languages may be spoken by office and clinical staff These additional languages are included as part of the provider specific information

Provider Address

The location where services and care are rendered

Provider Site Status

Accepting New Patients The provider site is able to see new patients

Accepting New Patients The provider site is only able to see patients who are alreadyassigned to the site

Available by Referral Only The provider site is only able to see patients who are referredby their primary care physician

Page 4 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility

Not Accepting New Patients The provider site is not able to add new patients to their site

Specialty Type

Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital

Wheelchair amp Accessibility Codes

This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms

Levels of Access

Accessibility Codes (see page 13 for a description of codesP EB IB R E T )

Basic Access

The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)

Limited Access

The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T

Medical Equipment Access

The office meets the standard below for exam tables and scales (T)

Page 5 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Directorio de proveedores de PHC - Glosario de teacuterminos

Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de

PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al

(800) 863-4155

Acreditacioacuten

Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa

Proveedores auxiliares

Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc

Certificacioacuten de la Junta

Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea

Cliacutenica de salud de la comunidad

Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad

Afiliaciones de grupo meacutedico

El consultorio o grupo meacutedico al que pertenece el proveedor

Hospital Asignado

El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital

Idiomas del proveedor

Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor

Direccioacuten del proveedor

El lugar donde se prestan los servicios y la atencioacuten

Estado del sitio del proveedor

Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos

Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio

Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a

Page 6 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

pacientes que son referidos por su meacutedico de atencioacuten primaria

Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro

No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio

Tipo de especialidad

Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital

Sillas de ruedas y coacutedigos de accesibilidad

Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos

Niveles de acceso

Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )

Acceso baacutesico

El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)

Acceso limitado

El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T

Acceso de equipo meacutedico

El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)

Page 7 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

NONDISCRIMINATION NOTICE

Discrimination is against the law Partnership HealthPlan of California follows

Federal civil rights laws Partnership HealthPlan of California does not

discriminate exclude people or treat them differently because of race color

national origin age disability or sex

Partnership HealthPlan of California provides

Free aids and services to people with disabilities to help them communicate

better such as

Qualified sign language interpreters

Written information in other formats (large print audio accessible

electronic formats other formats)

Free language services to people whose primary language is not English

such as

Qualified interpreters

Information written in other languages

If you need these services contact Partnership HealthPlan of California between

8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well

please call (800) 735-2929 or 711

Page 8 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

HOW TO FILE A GRIEVANCE

If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another

way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan

of California You can file a grievance by phone in writing in person or electronically

bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or

if you cannot hear or speak well please call (800) 735-2929 or 711

bull In writing Fill out a complaint form or write a letter and send it to

Partnership HealthPlan of California

4665 Business Center Drive

Fairfield CA 94534

OR

Partnership HealthPlan of California

3688 Avtech Parkway

Redding CA 96002

bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance

bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg

OFFICE OF CIVIL RIGHTS

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights

by phone in writing or electronically

bull By phone Call (800) 368-1019 If you cannot speak or hear well please call

TTYTDD (800) 537-7697

bull In writing Fill out a complaint form or send a letter to

US Department of Health and Human Services

200 Independence Avenue SW

Room 509F HHH Building

Washington DC 20201

Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml

bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 1 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

How to use this list

1 Pick two primary care providers (PCPs) One will be your first choice and the other will be your second choice Weask you to pick a second choice in case your first choice is not available

2 Write the names and the provider numbers of the primary care providers that you picked on the enclosed PrimaryCare Provider Selection Form Call our Members Services Department to make sure the doctor or medical group isavailable

3 Return the Primary Care Selection Form to PHC using the enclosed postage paid return envelope

4 You can access some Medi-Cal benefits without an authorization from your PCP Please refer to your MemberHandbook or call the PHC Member Services Department for more information about these services

5 Some hospitals andor primary care providers may not provide one or more of the following services that arecovered benefits family planning contraceptive services including emergency contraception sterilization includingtubal ligation or abortion You can obtain more information about these services before you choose your PCP bycalling your prospective primary care provider or by calling the PHCrsquos Member Services Department at(800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711

6 Members are encouraged to pick a Primary Care Provider (PCP) that is closest to their home However memberscan choose any PCP in their County that is available in this Provider Directory

7 The telephone number listed under each site in this directory is the same number to call after normal businesshours

If you need help filling out the Primary Care Selection Form or if you have any questions about choosing a primary care provider please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711

Your PCP will give you a referral to send you to a specialist if you need one A specialist is a doctor who has extra education in one area of medicine Your PCP will work with you to choose a specialist

For some types of care your PCP or specialist will need to ask for approval before you get the care This is called prior authorization or pre-approval It means that PHC agrees that the care is medically necessary

If you have any questions concerning handicapped accessibility please call our Member Services Department at (800) 863-4155 TTY Users Call the California Relay Service at (800) 735-2929 or call 711

Page 2 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Para usar esta lista

1 Escoja dos proveedores de atencioacuten primaria (PCP) El primero seraacute el meacutedico que usted prefiere y el segundoseraacute el que prefiere en segundo lugar Le pedimos que seleccione dos en caso que el doctor que prefiere no esteacutedisponible

2 Escriba los nombres y el nuacutemero de proveedor de cada uno de los dos meacutedicos que escogioacute en el formulario quese llama Primary Care Provider Selection Form Llame a Nuestro Departamento de Servicio al Miembro paraasegurarse de que el doctor o el grupo medico estaacute disponible

3 Regrese el formulario por correo a PHC en el sobre con sello que le incluimos

4 Usted puede recibir algunos beneficios de Medi-Cal sin ninguna autorizacioacuten de su doctor primario Por favor dereferir a su Manual para Miembros o llame al departamento de servicios para miembro de PHC para maacutesinformacioacuten sobre estos servicios

5 Algunos hospitales o proveedores de atencioacuten primaria puede que no ofrezcan uno o maacutes de los siguientesbeneficios que estaacuten cubiertos como planificacioacuten familiar servicios anticonceptivos incluyendo anticonceptivo deemergencia esterilizacioacuten incluyendo ligadura de las trompas o aborto Usted puede recibir maacutes informacioacuten deestos servicios antes de escoger a su PCP si llama a su prospectivo proveedor de atencioacuten primaria o si llama alDepartamento de Servicios para Miembros de PHC al (800) 863-4155 (TTY (800) 735-2929 or 711)

6 Animados a miembros a escoger el proveedor primario (PCP) que esteacute maacutes cerca de su casa Sin embargomiembros pueden escoger cualquier PCP en su condado que esteacute disponible en este Directorio de Proveedores

7 El nuacutemero de teleacutefono enumerado debajo de cada sitio en el directorio es el mismo nuacutemero para llamar despueacutes dehoras normales del negocio

Si necesita ayuda para completar el formulario que se llama Primary Care Provider Selection Form o si tiene preguntas sobre coacutemo escoger un proveedor de atencioacuten primaria por favor llame a nuestro Departamento de Servicios para Miembros al (800) 863-4155 (TTY (800) 735-2929 or 711)

Su PCP le daraacute una referencia para enviarlo a un especialista si lo necesita Un especialista es un meacutedico que tiene educacioacuten adicional en un aacuterea de la medicina Su PCP trabajaraacute con usted para elegir un especialista

Para algunos tipos de cuidado su PCP o especialista necesitaraacute pedir autorizacioacuten antes de que usted obtenga la atencioacuten meacutedica Esto se llama autorizacioacuten o aprobacioacuten previa Esto significa que PHC esteacute de acuerdo en que el cuidado es meacutedicamente necesario

Si tiene cualquier pregunta sobre acceso para incapacitados por favor llame al Departamento de Servicios para Miembros al ((800) 863-4155 (TTY (800) 735-2929 or 711)

Page 3 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC Provider Directory - Glossary of Terms

Here youll find definitions of basic terms used in the PHC Provider Directory If you are unable to

find an answer to your question please call Member Services at

(800) 863-4155

Accreditation

When a hospital goes through a review to assess the quality of its systems and processes by an outside organization

Ancillary Provider

An ancillary provider includes durable medical equipment provider physical therapist occupational therapist etc

Board Certification

Board certification means the physician completed additional education and training in an area of medicine and passed an examination that certifies he or she has expertise in this area

Community Health Clinic

This is a clinic staffed by a group of doctors and nurses located in a community

Medical Group Affiliations

The practice or medical group the provider belongs to

Assigned Hospital

The hospital that your provider will send you to when you need care unless the care is not available at this hospital

Provider Languages

Languages spoken by provider Additionally other languages may be spoken by office and clinical staff These additional languages are included as part of the provider specific information

Provider Address

The location where services and care are rendered

Provider Site Status

Accepting New Patients The provider site is able to see new patients

Accepting New Patients The provider site is only able to see patients who are alreadyassigned to the site

Available by Referral Only The provider site is only able to see patients who are referredby their primary care physician

Page 4 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility

Not Accepting New Patients The provider site is not able to add new patients to their site

Specialty Type

Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital

Wheelchair amp Accessibility Codes

This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms

Levels of Access

Accessibility Codes (see page 13 for a description of codesP EB IB R E T )

Basic Access

The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)

Limited Access

The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T

Medical Equipment Access

The office meets the standard below for exam tables and scales (T)

Page 5 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Directorio de proveedores de PHC - Glosario de teacuterminos

Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de

PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al

(800) 863-4155

Acreditacioacuten

Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa

Proveedores auxiliares

Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc

Certificacioacuten de la Junta

Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea

Cliacutenica de salud de la comunidad

Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad

Afiliaciones de grupo meacutedico

El consultorio o grupo meacutedico al que pertenece el proveedor

Hospital Asignado

El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital

Idiomas del proveedor

Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor

Direccioacuten del proveedor

El lugar donde se prestan los servicios y la atencioacuten

Estado del sitio del proveedor

Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos

Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio

Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a

Page 6 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

pacientes que son referidos por su meacutedico de atencioacuten primaria

Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro

No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio

Tipo de especialidad

Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital

Sillas de ruedas y coacutedigos de accesibilidad

Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos

Niveles de acceso

Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )

Acceso baacutesico

El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)

Acceso limitado

El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T

Acceso de equipo meacutedico

El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)

Page 7 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

NONDISCRIMINATION NOTICE

Discrimination is against the law Partnership HealthPlan of California follows

Federal civil rights laws Partnership HealthPlan of California does not

discriminate exclude people or treat them differently because of race color

national origin age disability or sex

Partnership HealthPlan of California provides

Free aids and services to people with disabilities to help them communicate

better such as

Qualified sign language interpreters

Written information in other formats (large print audio accessible

electronic formats other formats)

Free language services to people whose primary language is not English

such as

Qualified interpreters

Information written in other languages

If you need these services contact Partnership HealthPlan of California between

8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well

please call (800) 735-2929 or 711

Page 8 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

HOW TO FILE A GRIEVANCE

If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another

way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan

of California You can file a grievance by phone in writing in person or electronically

bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or

if you cannot hear or speak well please call (800) 735-2929 or 711

bull In writing Fill out a complaint form or write a letter and send it to

Partnership HealthPlan of California

4665 Business Center Drive

Fairfield CA 94534

OR

Partnership HealthPlan of California

3688 Avtech Parkway

Redding CA 96002

bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance

bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg

OFFICE OF CIVIL RIGHTS

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights

by phone in writing or electronically

bull By phone Call (800) 368-1019 If you cannot speak or hear well please call

TTYTDD (800) 537-7697

bull In writing Fill out a complaint form or send a letter to

US Department of Health and Human Services

200 Independence Avenue SW

Room 509F HHH Building

Washington DC 20201

Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml

bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 2 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Para usar esta lista

1 Escoja dos proveedores de atencioacuten primaria (PCP) El primero seraacute el meacutedico que usted prefiere y el segundoseraacute el que prefiere en segundo lugar Le pedimos que seleccione dos en caso que el doctor que prefiere no esteacutedisponible

2 Escriba los nombres y el nuacutemero de proveedor de cada uno de los dos meacutedicos que escogioacute en el formulario quese llama Primary Care Provider Selection Form Llame a Nuestro Departamento de Servicio al Miembro paraasegurarse de que el doctor o el grupo medico estaacute disponible

3 Regrese el formulario por correo a PHC en el sobre con sello que le incluimos

4 Usted puede recibir algunos beneficios de Medi-Cal sin ninguna autorizacioacuten de su doctor primario Por favor dereferir a su Manual para Miembros o llame al departamento de servicios para miembro de PHC para maacutesinformacioacuten sobre estos servicios

5 Algunos hospitales o proveedores de atencioacuten primaria puede que no ofrezcan uno o maacutes de los siguientesbeneficios que estaacuten cubiertos como planificacioacuten familiar servicios anticonceptivos incluyendo anticonceptivo deemergencia esterilizacioacuten incluyendo ligadura de las trompas o aborto Usted puede recibir maacutes informacioacuten deestos servicios antes de escoger a su PCP si llama a su prospectivo proveedor de atencioacuten primaria o si llama alDepartamento de Servicios para Miembros de PHC al (800) 863-4155 (TTY (800) 735-2929 or 711)

6 Animados a miembros a escoger el proveedor primario (PCP) que esteacute maacutes cerca de su casa Sin embargomiembros pueden escoger cualquier PCP en su condado que esteacute disponible en este Directorio de Proveedores

7 El nuacutemero de teleacutefono enumerado debajo de cada sitio en el directorio es el mismo nuacutemero para llamar despueacutes dehoras normales del negocio

Si necesita ayuda para completar el formulario que se llama Primary Care Provider Selection Form o si tiene preguntas sobre coacutemo escoger un proveedor de atencioacuten primaria por favor llame a nuestro Departamento de Servicios para Miembros al (800) 863-4155 (TTY (800) 735-2929 or 711)

Su PCP le daraacute una referencia para enviarlo a un especialista si lo necesita Un especialista es un meacutedico que tiene educacioacuten adicional en un aacuterea de la medicina Su PCP trabajaraacute con usted para elegir un especialista

Para algunos tipos de cuidado su PCP o especialista necesitaraacute pedir autorizacioacuten antes de que usted obtenga la atencioacuten meacutedica Esto se llama autorizacioacuten o aprobacioacuten previa Esto significa que PHC esteacute de acuerdo en que el cuidado es meacutedicamente necesario

Si tiene cualquier pregunta sobre acceso para incapacitados por favor llame al Departamento de Servicios para Miembros al ((800) 863-4155 (TTY (800) 735-2929 or 711)

Page 3 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC Provider Directory - Glossary of Terms

Here youll find definitions of basic terms used in the PHC Provider Directory If you are unable to

find an answer to your question please call Member Services at

(800) 863-4155

Accreditation

When a hospital goes through a review to assess the quality of its systems and processes by an outside organization

Ancillary Provider

An ancillary provider includes durable medical equipment provider physical therapist occupational therapist etc

Board Certification

Board certification means the physician completed additional education and training in an area of medicine and passed an examination that certifies he or she has expertise in this area

Community Health Clinic

This is a clinic staffed by a group of doctors and nurses located in a community

Medical Group Affiliations

The practice or medical group the provider belongs to

Assigned Hospital

The hospital that your provider will send you to when you need care unless the care is not available at this hospital

Provider Languages

Languages spoken by provider Additionally other languages may be spoken by office and clinical staff These additional languages are included as part of the provider specific information

Provider Address

The location where services and care are rendered

Provider Site Status

Accepting New Patients The provider site is able to see new patients

Accepting New Patients The provider site is only able to see patients who are alreadyassigned to the site

Available by Referral Only The provider site is only able to see patients who are referredby their primary care physician

Page 4 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility

Not Accepting New Patients The provider site is not able to add new patients to their site

Specialty Type

Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital

Wheelchair amp Accessibility Codes

This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms

Levels of Access

Accessibility Codes (see page 13 for a description of codesP EB IB R E T )

Basic Access

The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)

Limited Access

The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T

Medical Equipment Access

The office meets the standard below for exam tables and scales (T)

Page 5 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Directorio de proveedores de PHC - Glosario de teacuterminos

Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de

PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al

(800) 863-4155

Acreditacioacuten

Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa

Proveedores auxiliares

Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc

Certificacioacuten de la Junta

Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea

Cliacutenica de salud de la comunidad

Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad

Afiliaciones de grupo meacutedico

El consultorio o grupo meacutedico al que pertenece el proveedor

Hospital Asignado

El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital

Idiomas del proveedor

Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor

Direccioacuten del proveedor

El lugar donde se prestan los servicios y la atencioacuten

Estado del sitio del proveedor

Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos

Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio

Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a

Page 6 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

pacientes que son referidos por su meacutedico de atencioacuten primaria

Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro

No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio

Tipo de especialidad

Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital

Sillas de ruedas y coacutedigos de accesibilidad

Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos

Niveles de acceso

Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )

Acceso baacutesico

El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)

Acceso limitado

El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T

Acceso de equipo meacutedico

El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)

Page 7 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

NONDISCRIMINATION NOTICE

Discrimination is against the law Partnership HealthPlan of California follows

Federal civil rights laws Partnership HealthPlan of California does not

discriminate exclude people or treat them differently because of race color

national origin age disability or sex

Partnership HealthPlan of California provides

Free aids and services to people with disabilities to help them communicate

better such as

Qualified sign language interpreters

Written information in other formats (large print audio accessible

electronic formats other formats)

Free language services to people whose primary language is not English

such as

Qualified interpreters

Information written in other languages

If you need these services contact Partnership HealthPlan of California between

8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well

please call (800) 735-2929 or 711

Page 8 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

HOW TO FILE A GRIEVANCE

If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another

way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan

of California You can file a grievance by phone in writing in person or electronically

bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or

if you cannot hear or speak well please call (800) 735-2929 or 711

bull In writing Fill out a complaint form or write a letter and send it to

Partnership HealthPlan of California

4665 Business Center Drive

Fairfield CA 94534

OR

Partnership HealthPlan of California

3688 Avtech Parkway

Redding CA 96002

bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance

bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg

OFFICE OF CIVIL RIGHTS

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights

by phone in writing or electronically

bull By phone Call (800) 368-1019 If you cannot speak or hear well please call

TTYTDD (800) 537-7697

bull In writing Fill out a complaint form or send a letter to

US Department of Health and Human Services

200 Independence Avenue SW

Room 509F HHH Building

Washington DC 20201

Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml

bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 3 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC Provider Directory - Glossary of Terms

Here youll find definitions of basic terms used in the PHC Provider Directory If you are unable to

find an answer to your question please call Member Services at

(800) 863-4155

Accreditation

When a hospital goes through a review to assess the quality of its systems and processes by an outside organization

Ancillary Provider

An ancillary provider includes durable medical equipment provider physical therapist occupational therapist etc

Board Certification

Board certification means the physician completed additional education and training in an area of medicine and passed an examination that certifies he or she has expertise in this area

Community Health Clinic

This is a clinic staffed by a group of doctors and nurses located in a community

Medical Group Affiliations

The practice or medical group the provider belongs to

Assigned Hospital

The hospital that your provider will send you to when you need care unless the care is not available at this hospital

Provider Languages

Languages spoken by provider Additionally other languages may be spoken by office and clinical staff These additional languages are included as part of the provider specific information

Provider Address

The location where services and care are rendered

Provider Site Status

Accepting New Patients The provider site is able to see new patients

Accepting New Patients The provider site is only able to see patients who are alreadyassigned to the site

Available by Referral Only The provider site is only able to see patients who are referredby their primary care physician

Page 4 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility

Not Accepting New Patients The provider site is not able to add new patients to their site

Specialty Type

Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital

Wheelchair amp Accessibility Codes

This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms

Levels of Access

Accessibility Codes (see page 13 for a description of codesP EB IB R E T )

Basic Access

The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)

Limited Access

The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T

Medical Equipment Access

The office meets the standard below for exam tables and scales (T)

Page 5 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Directorio de proveedores de PHC - Glosario de teacuterminos

Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de

PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al

(800) 863-4155

Acreditacioacuten

Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa

Proveedores auxiliares

Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc

Certificacioacuten de la Junta

Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea

Cliacutenica de salud de la comunidad

Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad

Afiliaciones de grupo meacutedico

El consultorio o grupo meacutedico al que pertenece el proveedor

Hospital Asignado

El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital

Idiomas del proveedor

Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor

Direccioacuten del proveedor

El lugar donde se prestan los servicios y la atencioacuten

Estado del sitio del proveedor

Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos

Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio

Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a

Page 6 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

pacientes que son referidos por su meacutedico de atencioacuten primaria

Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro

No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio

Tipo de especialidad

Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital

Sillas de ruedas y coacutedigos de accesibilidad

Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos

Niveles de acceso

Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )

Acceso baacutesico

El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)

Acceso limitado

El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T

Acceso de equipo meacutedico

El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)

Page 7 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

NONDISCRIMINATION NOTICE

Discrimination is against the law Partnership HealthPlan of California follows

Federal civil rights laws Partnership HealthPlan of California does not

discriminate exclude people or treat them differently because of race color

national origin age disability or sex

Partnership HealthPlan of California provides

Free aids and services to people with disabilities to help them communicate

better such as

Qualified sign language interpreters

Written information in other formats (large print audio accessible

electronic formats other formats)

Free language services to people whose primary language is not English

such as

Qualified interpreters

Information written in other languages

If you need these services contact Partnership HealthPlan of California between

8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well

please call (800) 735-2929 or 711

Page 8 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

HOW TO FILE A GRIEVANCE

If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another

way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan

of California You can file a grievance by phone in writing in person or electronically

bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or

if you cannot hear or speak well please call (800) 735-2929 or 711

bull In writing Fill out a complaint form or write a letter and send it to

Partnership HealthPlan of California

4665 Business Center Drive

Fairfield CA 94534

OR

Partnership HealthPlan of California

3688 Avtech Parkway

Redding CA 96002

bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance

bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg

OFFICE OF CIVIL RIGHTS

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights

by phone in writing or electronically

bull By phone Call (800) 368-1019 If you cannot speak or hear well please call

TTYTDD (800) 537-7697

bull In writing Fill out a complaint form or send a letter to

US Department of Health and Human Services

200 Independence Avenue SW

Room 509F HHH Building

Washington DC 20201

Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml

bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 4 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Available only through a hospital or facility The provider does not see patients in anoffice setting The provider only works with patients who are receiving care at a hospital orfacility

Not Accepting New Patients The provider site is not able to add new patients to their site

Specialty Type

Allows searching by the providerrsquos medical specialty or the type of facility For example if you are looking for a Dermatologist select Dermatology from the list Note Some physicians may have more than one specialty For facilities if you are looking for a hospital for example select hospital

Wheelchair amp Accessibility Codes

This information is for people with disabilities to help them find an accessible office Each office is evaluated on the level of access for parking building elevator doctorrsquos office exam room and restrooms

Levels of Access

Accessibility Codes (see page 13 for a description of codesP EB IB R E T )

Basic Access

The office meets the standards below for parking exterior and interior building restrooms and exam rooms (P EB IB R and E)

Limited Access

The office does not meet one or more of the standards for parking exterior and interior building restrooms and exam rooms (P EB IB R and E) See page 13 for a description of codesP EB IB R E T

Medical Equipment Access

The office meets the standard below for exam tables and scales (T)

Page 5 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Directorio de proveedores de PHC - Glosario de teacuterminos

Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de

PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al

(800) 863-4155

Acreditacioacuten

Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa

Proveedores auxiliares

Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc

Certificacioacuten de la Junta

Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea

Cliacutenica de salud de la comunidad

Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad

Afiliaciones de grupo meacutedico

El consultorio o grupo meacutedico al que pertenece el proveedor

Hospital Asignado

El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital

Idiomas del proveedor

Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor

Direccioacuten del proveedor

El lugar donde se prestan los servicios y la atencioacuten

Estado del sitio del proveedor

Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos

Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio

Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a

Page 6 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

pacientes que son referidos por su meacutedico de atencioacuten primaria

Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro

No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio

Tipo de especialidad

Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital

Sillas de ruedas y coacutedigos de accesibilidad

Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos

Niveles de acceso

Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )

Acceso baacutesico

El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)

Acceso limitado

El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T

Acceso de equipo meacutedico

El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)

Page 7 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

NONDISCRIMINATION NOTICE

Discrimination is against the law Partnership HealthPlan of California follows

Federal civil rights laws Partnership HealthPlan of California does not

discriminate exclude people or treat them differently because of race color

national origin age disability or sex

Partnership HealthPlan of California provides

Free aids and services to people with disabilities to help them communicate

better such as

Qualified sign language interpreters

Written information in other formats (large print audio accessible

electronic formats other formats)

Free language services to people whose primary language is not English

such as

Qualified interpreters

Information written in other languages

If you need these services contact Partnership HealthPlan of California between

8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well

please call (800) 735-2929 or 711

Page 8 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

HOW TO FILE A GRIEVANCE

If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another

way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan

of California You can file a grievance by phone in writing in person or electronically

bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or

if you cannot hear or speak well please call (800) 735-2929 or 711

bull In writing Fill out a complaint form or write a letter and send it to

Partnership HealthPlan of California

4665 Business Center Drive

Fairfield CA 94534

OR

Partnership HealthPlan of California

3688 Avtech Parkway

Redding CA 96002

bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance

bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg

OFFICE OF CIVIL RIGHTS

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights

by phone in writing or electronically

bull By phone Call (800) 368-1019 If you cannot speak or hear well please call

TTYTDD (800) 537-7697

bull In writing Fill out a complaint form or send a letter to

US Department of Health and Human Services

200 Independence Avenue SW

Room 509F HHH Building

Washington DC 20201

Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml

bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 5 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Directorio de proveedores de PHC - Glosario de teacuterminos

Aquiacute encontraraacute las definiciones de teacuterminos baacutesicos utilizados en el Directorio de proveedores de

PHC Si no puede encontrar una respuesta a su pregunta llame a Servicios al Miembro al

(800) 863-4155

Acreditacioacuten

Cuando un hospital se somete a una revisioacuten para evaluar la calidad de sus procesos y sistemas por una organizacioacuten externa

Proveedores auxiliares

Un proveedor auxiliar incluye proveedores de equipo meacutedico duradero fisioterapeutas terapeutas ocupacionales etc

Certificacioacuten de la Junta

Certificacioacuten de la Junta significa que el meacutedico completoacute educacioacuten y capacitacioacuten adicional en un aacuterea de la medicina y aproboacute un examen que certifica que eacutel o ella tiene experiencia en esta aacuterea

Cliacutenica de salud de la comunidad

Esta es una cliacutenica que cuenta con un grupo de meacutedicos y enfermeros ubicado en la comunidad

Afiliaciones de grupo meacutedico

El consultorio o grupo meacutedico al que pertenece el proveedor

Hospital Asignado

El hospital al que su proveedor le enviaraacute a cuando usted necesite atencioacuten a menos que la atencioacuten no esteacute disponible en este hospital

Idiomas del proveedor

Idiomas hablados por el proveedor Ademaacutes es posible que personal administrativo y cliacutenico tambieacuten hable otros idiomas Estos idiomas adicionales se incluyeron como parte de la informacioacuten especiacutefica del proveedor

Direccioacuten del proveedor

El lugar donde se prestan los servicios y la atencioacuten

Estado del sitio del proveedor

Acepta pacientes nuevos el sitio del proveedor puede ver a pacientes nuevos

Acepta pacientes existentes el sitio del proveedor solo puede ver a pacientes que yaestaacuten asignados al sitio

Disponible con referencia uacutenicamente el sitio del proveedor uacutenicamente puede ver a

Page 6 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

pacientes que son referidos por su meacutedico de atencioacuten primaria

Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro

No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio

Tipo de especialidad

Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital

Sillas de ruedas y coacutedigos de accesibilidad

Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos

Niveles de acceso

Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )

Acceso baacutesico

El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)

Acceso limitado

El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T

Acceso de equipo meacutedico

El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)

Page 7 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

NONDISCRIMINATION NOTICE

Discrimination is against the law Partnership HealthPlan of California follows

Federal civil rights laws Partnership HealthPlan of California does not

discriminate exclude people or treat them differently because of race color

national origin age disability or sex

Partnership HealthPlan of California provides

Free aids and services to people with disabilities to help them communicate

better such as

Qualified sign language interpreters

Written information in other formats (large print audio accessible

electronic formats other formats)

Free language services to people whose primary language is not English

such as

Qualified interpreters

Information written in other languages

If you need these services contact Partnership HealthPlan of California between

8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well

please call (800) 735-2929 or 711

Page 8 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

HOW TO FILE A GRIEVANCE

If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another

way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan

of California You can file a grievance by phone in writing in person or electronically

bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or

if you cannot hear or speak well please call (800) 735-2929 or 711

bull In writing Fill out a complaint form or write a letter and send it to

Partnership HealthPlan of California

4665 Business Center Drive

Fairfield CA 94534

OR

Partnership HealthPlan of California

3688 Avtech Parkway

Redding CA 96002

bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance

bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg

OFFICE OF CIVIL RIGHTS

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights

by phone in writing or electronically

bull By phone Call (800) 368-1019 If you cannot speak or hear well please call

TTYTDD (800) 537-7697

bull In writing Fill out a complaint form or send a letter to

US Department of Health and Human Services

200 Independence Avenue SW

Room 509F HHH Building

Washington DC 20201

Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml

bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 6 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

pacientes que son referidos por su meacutedico de atencioacuten primaria

Disponible uacutenicamente por medio de un hospital o centro el proveedor no atiende apacientes en un entorno de consultorio El proveedor uacutenicamente trabaja con los pacientesque estaacuten recibiendo atencioacuten en un hospital o centro

No acepta nuevos pacientes el sitio del proveedor no puede agregar nuevos pacientesen su sitio

Tipo de especialidad

Permite la buacutesqueda por especialidad meacutedica del proveedor o el tipo de centro Por ejemplo si usted estaacute buscando un dermatoacutelogo seleccione Dermatologiacutea de la lista Nota Algunos meacutedicos pueden tener maacutes de una especialidad Para centros de salud si usted estaacute buscando un hospital por ejemplo seleccione hospital

Sillas de ruedas y coacutedigos de accesibilidad

Esta informacioacuten es para las personas con discapacidades para ayudarles a encontrar un consultorio accesible Cada cliacutenica se evaluacutea en el nivel de acceso para estacionamiento edificio ascensor sala de examen del consultorio meacutedico y bantildeos

Niveles de acceso

Coacutedigos de accesibilidad (consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T )

Acceso baacutesico

El consultorio cumple con los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (parking exterior and interior building restrooms and exam rooms P EB IB R y E)

Acceso limitado

El consultorio no cumple con uno o maacutes de los estaacutendares a continuacioacuten para estacionamiento interior y exterior del edificio bantildeos y salas de examen (P EB IB R y E) Consulte la paacutegina 13 para obtener una descripcioacuten de los coacutedigosP EB IB R E T

Acceso de equipo meacutedico

El consultorio cumple con los estaacutendares a continuacioacuten para mesas de examen y balanzas (T)

Page 7 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

NONDISCRIMINATION NOTICE

Discrimination is against the law Partnership HealthPlan of California follows

Federal civil rights laws Partnership HealthPlan of California does not

discriminate exclude people or treat them differently because of race color

national origin age disability or sex

Partnership HealthPlan of California provides

Free aids and services to people with disabilities to help them communicate

better such as

Qualified sign language interpreters

Written information in other formats (large print audio accessible

electronic formats other formats)

Free language services to people whose primary language is not English

such as

Qualified interpreters

Information written in other languages

If you need these services contact Partnership HealthPlan of California between

8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well

please call (800) 735-2929 or 711

Page 8 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

HOW TO FILE A GRIEVANCE

If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another

way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan

of California You can file a grievance by phone in writing in person or electronically

bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or

if you cannot hear or speak well please call (800) 735-2929 or 711

bull In writing Fill out a complaint form or write a letter and send it to

Partnership HealthPlan of California

4665 Business Center Drive

Fairfield CA 94534

OR

Partnership HealthPlan of California

3688 Avtech Parkway

Redding CA 96002

bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance

bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg

OFFICE OF CIVIL RIGHTS

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights

by phone in writing or electronically

bull By phone Call (800) 368-1019 If you cannot speak or hear well please call

TTYTDD (800) 537-7697

bull In writing Fill out a complaint form or send a letter to

US Department of Health and Human Services

200 Independence Avenue SW

Room 509F HHH Building

Washington DC 20201

Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml

bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 7 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

NONDISCRIMINATION NOTICE

Discrimination is against the law Partnership HealthPlan of California follows

Federal civil rights laws Partnership HealthPlan of California does not

discriminate exclude people or treat them differently because of race color

national origin age disability or sex

Partnership HealthPlan of California provides

Free aids and services to people with disabilities to help them communicate

better such as

Qualified sign language interpreters

Written information in other formats (large print audio accessible

electronic formats other formats)

Free language services to people whose primary language is not English

such as

Qualified interpreters

Information written in other languages

If you need these services contact Partnership HealthPlan of California between

8 am ndash 5 pm by calling (800) 863-4155 Or if you cannot hear or speak well

please call (800) 735-2929 or 711

Page 8 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

HOW TO FILE A GRIEVANCE

If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another

way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan

of California You can file a grievance by phone in writing in person or electronically

bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or

if you cannot hear or speak well please call (800) 735-2929 or 711

bull In writing Fill out a complaint form or write a letter and send it to

Partnership HealthPlan of California

4665 Business Center Drive

Fairfield CA 94534

OR

Partnership HealthPlan of California

3688 Avtech Parkway

Redding CA 96002

bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance

bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg

OFFICE OF CIVIL RIGHTS

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights

by phone in writing or electronically

bull By phone Call (800) 368-1019 If you cannot speak or hear well please call

TTYTDD (800) 537-7697

bull In writing Fill out a complaint form or send a letter to

US Department of Health and Human Services

200 Independence Avenue SW

Room 509F HHH Building

Washington DC 20201

Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml

bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 8 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

HOW TO FILE A GRIEVANCE

If you believe that Partnership HealthPlan of California has failed to provide these services or discriminated in another

way on the basis of race color national origin age disability or sex you can file a grievance with Partnership HealthPlan

of California You can file a grievance by phone in writing in person or electronically

bull By phone Contact Partnership HealthPlan of California between 8 am ndash 5 pm by calling (800) 863-4155 Or

if you cannot hear or speak well please call (800) 735-2929 or 711

bull In writing Fill out a complaint form or write a letter and send it to

Partnership HealthPlan of California

4665 Business Center Drive

Fairfield CA 94534

OR

Partnership HealthPlan of California

3688 Avtech Parkway

Redding CA 96002

bull In person Visit your doctorrsquos office or Partnership HealthPlan of California and say you want to file a grievance

bull Electronically Visit website Partnership HealthPlan of California at wwwpartnershiphporg

OFFICE OF CIVIL RIGHTS

You can also file a civil rights complaint with the US Department of Health and Human Services Office for Civil Rights

by phone in writing or electronically

bull By phone Call (800) 368-1019 If you cannot speak or hear well please call

TTYTDD (800) 537-7697

bull In writing Fill out a complaint form or send a letter to

US Department of Health and Human Services

200 Independence Avenue SW

Room 509F HHH Building

Washington DC 20201

Complaint forms are available at httpwwwhhsgovocrofficefileindexhtml

bull Electronically Visit the Office for Civil Rights Complaint Portal at httpsocrportalhhsgovocrportallobbyjsf

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 9 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

AVISO DE NO DISCRIMINACIOacuteN

La discriminacioacuten estaacute prohibida por ley Partnership HealthPlan of California cumple las leyes federales de derechos civiles Partnership HealthPlan of California no discrimina excluye ni trata a personas de manera diferente debido a la raza color nacionalidad edad discapacidad o sexo

Partnership HealthPlan of California proporciona

Ayuda gratuita y servicios a las personas con discapacidadespara comunicarse mejor como

Inteacuterpretes de lenguaje de sentildeas calificados

Informacioacuten escrita en otros formatos (letra grandeaudio formatos electroacutenicos accesibles otros formatos)

Servicios gratuitos de idiomas para las personas cuyo idiomaprimario no es el ingleacutes como

Inteacuterpretes calificados

Informacioacuten escrita en otros idiomas

Si necesita estos servicios comuniacutequese a Partnership HealthPlan of California de 8 a m a 5 p m llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llame al (800) 735-2929 o 711

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 10 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

COMO PRESENTAR UNA QUEJA

Si usted cree que Partnership HealthPlan of California ha fallado en proveer estos servicios o ha discriminado en otra manera basada en raza color nacionalidad edad discapacidad o sexo usted puede presentar una queja ante Partnership HealthPlan of California Usted puede presentar una queja por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Poacutengase en contacto con Partnership HealthPlan of California entre 8 am -5 pm llamando al (800) 863-4155 O si no puede escuchar o hablar bien por favor llameal (800) 735-2929 o 711

Por escrito Llene un formulario de reclamo o escriba una carta y enviacuteela a

Partnership HealthPlan of California4665 Business Center DriveFairfield CA 94534

O

Partnership HealthPlan of California3688 Avtech ParkwayRedding CA 96002

En persona Visite al consultorio de su meacutedico o Partnership HealthPlan of California y digaque desea presentar una queja

Por viacutea electroacutenica Visite el sitio web de Partnership HealthPlan of California enwwwpartnershiphporg

OFICINA DE DERECHOS CIVILES

Usted tambieacuten puede presentar una queja de derechos civiles ante la Oficina de Derechos Civiles del Departamento de Salud y Servicios Humanos de EE UU por teleacutefono por escrito o por viacutea electroacutenica

Por teleacutefono Llame al (800) 368-1019 Si no puede escuchar o hablar bien favor de llamaral TTYTDD (800) 537-7697

Por escrito Llene un formulario de reclamo o enviacutee una carta a

US Department of Health and Human Services200 Independence Avenue SWRoom 509F HHH BuildingWashington DC 20201

Los formularios de quejas estaacuten disponibles en httpwwwhhsgovocrofficefileindexhtml

Por viacutea electroacutenica Visite el Portal de Reclamos de la Oficina de Derechos Civiles alhttpsocrportalhhsgovocrportallobbyjsf

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 11 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

LANGUAGE ASSISTANCE English

ATTENTION If you speak another language language assistance services free of

charge are available to you Call (800) 863-4155 (TTY (800) 735-2929 or 711)

Espantildeol (Spanish)

ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de

asistencia linguumliacutestica Llame al (800) 863-4155 (TTY (800) 735-2929 or 711)

Русский (Russian)

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны

бесплатные услуги перевода Звоните (800) 863-4155 (TTY (800) 735-2929 or

711)

Tiếng Việt (Vietnamese)

CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh

cho bạn Gọi số (800) 863-4155 (TTY (800) 735-2929 or 711)

Tagalog (Tagalog Filipino)

PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga

serbisyo ng tulong sa wika nang walang bayad Tumawag sa (800) 863-4155 (TTY

(800) 735-2929 or 711)

한국어 (Korean)

주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실

수 있습니다 (800) 863-4155 (TTY (800) 735-2929 or 711) 번으로 전화해

주십시오

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 12 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

繁體中文(Chinese)

注意如果您使用繁體中文您可以免費獲得語言援助服務請致電

(800) 863-4155 (TTY (800) 735-2929 or 711)

Հայերեն (Armenian)

ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն ապա ձեզ անվճար

կարող են տրամադրվել լեզվական աջակցության ծառայություններ

Զանգահարեք (800) 863-4155 (TTY (հեռատիպ) (800) 735-2929 or 711)

(Farsi) فارسی

اگر به زبان فارسی گفتگو می کنید تسهیت زبانی بصورت رایگان برای شما توجه

تماس بگیرید (TTY (800) 735-2929 or 711) 4155-863 (800)فراهم می باشد با

日本語 (Japanese)

注意事項日本語を話される場合無料の言語支援をご利用いただ

けます(800) 863-4155 (TTY (800) 735-2929 or 711) までお電話にてご

連絡ください

Hmoob (Hmong)

LUS CEEV Yog tias koj hais lus Hmoob cov kev pab txog lus muaj

kev pab dawb rau koj Hu rau (800) 863-4155 (TTY (800) 735-2929 or 711)

ਪਜਾਬੀ (Punjabi)

ਧਿਆਨ ਧਿਓ ਜ ਤਸ ਪਜਾਬ ਬਲਿ ਹ ਤਾ ਭਾਸ਼ਾ ਧ ਚ ਸਹਾਇਤਾ ਸ ਾ ਤਹਾਡ ਲਈ

ਮਫਤ ਉਪਲਬਿ ਹ (800) 863-4155 (TTY (800) 735-2929 or 711) ਤ ਕਾਲ ਕਰ

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 13 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

(Arabic) العربية

تتحدث اذكر اللغة فإن خدمات ملحوظة إذا كنت

711)رقم هاتف الصم والبكم 4155-863 (800)المساعدة اللغوية تتوافر لك بالمجان اتصل برقم

or (800) 735-2929)

ह दी (Hindi)

धयान द यदि आप ह दी बोलत ह तो आपक लिए मफत म भाषा सहायता सवाए

उपलबध ह (800) 863-4155 (TTY (800) 735-2929 or 711) पर कॉल कर

ภาษาไทย (Thai)

เรยน ถาคณพดภาษาไทยคณสามารถใชบรการชวยเหลอทางภาษาไดฟร

โทร (800) 863-4155 (TTY (800) 735-2929 or 711)

មែរ (Cambodian)

រយន ររ ើសននកនយ មែ រសជនយមននក

រោយមនគន ល គចនស ររ ើនក ច ទ សទ (800) 863-4155

(TTY (800) 735-2929 or 711)

ພາສາລາວ (Laotian)

ໂປດຊາບ ຖາວາ ທານເວ າພາສາ ລາວ ການບ ລ ການຊວຍເຫ ອດານພາສາ

ໂດຍບ ເສຽຄາ ແມນມພອມໃຫທານ ໂທຣ (800) 863-4155 (TTY (800)

735-2929 or 711)

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 14 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Accessibility Standards for Seniors and Persons with Disabilities

This directory now lists codes to define ldquoaccessibilityrdquo standards These standards are meant to help seniors and persons with disabilities The intent is that members can get in and around offices safely and without help from others These codes are not yet listed for all providers If you do not see these codes listed under a certain providerrsquos name just call the office You can ask if they have the type of access that you need

Levels of Access

Basic Access The office meets the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Limited Access The office does not meet one or more of the standards below for parking interior and exterior building exam rooms and restrooms (P EB IB R and E)

Medical Equipment Access The office meets the standard below for exam tables and scales (T)

Accessibility Codes

= Wheelchair Accessible

P = Parking Accessible parking spaces including van accessible spaces(s) are present Pathways have curb ramps between the parking lot office and at drop off areas

EB = Exterior Building Curb ramps and other ramps to the building are not too long Ramps are wide enough for a wheelchair or scooter Handrails are on both sides of the ramp There is an accessible entrance to the building Doors open wide enough for a wheelchair or scooter and have handles that are easy to use

IB = Interior Building Pathways are wide enough for a wheelchair or scooter Stairs if present have handrails If there is an elevator it can be used at all times the building is open The elevator has easy to hear sounds and Braille buttons within reach The elevator has enough room for a wheelchair or scooter to turn around If there is a platform lift it can be used without help

R = Restroom The restroom doors are wide enough for a wheelchair or scooter The restroom has enough room for a wheelchair or scooter to turn around and close the door There are grab bars which allow easy transfer from wheelchair to toilet The sink is easy to get to and the faucets soap and toilet paper are easy to reach and use

E = Exam Room The doors to the exam rooms open wide enough for a wheelchair or scooter The exam room has enough room for a wheelchair or scooter to turn around

T = Exam TableScale The exam table moves up and down and has space next to it for a wheelchair or scooter The weight scale can be used by patients with wheelchairs or scooters

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 15 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Normas de Accesibilidad para Personas Mayores y Personas con Discapacidades

Este directorio enumera los coacutedigos para definir las normas de ldquoaccesibilidadrdquo Estas normas pretenden ayudar a personas mayores y a personas con discapacidades La intencioacuten es que los miembros puedan entrar y desplazarse por las oficinas de manera segura y sin ayuda de otros Estos coacutedigos todaviacutea no se encuentran enumerados para todos los proveedores Si no ve estos coacutedigos enumerados bajo el nombre de cierto proveedor llame a la oficina del proveedor Puede preguntar si tienen el tipo de acceso que usted necesita

Niveles de acceso Acceso baacutesico La oficina cumple con las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso limitadoLa oficina no cumple con una o maacutes de las normas de estacionamiento interior y exterior del edificio salas de examen y bantildeos (P EB IB R y E)

Acceso de equipo meacutedicoLa oficina cumple con la norma para camillas de examen y baacutesculas (T)

Coacutedigos de accesibilidad

= Accesible a silla de ruedas (Wheelchair Accessible)

P = Estacionamiento (Parking) Espacios de estacionamiento accesible incluyendo espacios accesibles para van estaacuten presente Las entradas tienen rampas de acceso en las aceras entre el estacionamiento la oficina y las aacutereas para dejar a las personas

EB = Exterior del edificio (Exterior Building) Las rampas en las aceras y otras rampas hacia el edificio no son demasiado largas Las rampas son suficientemente anchas para permitir el acceso de una silla de ruedas o un scooter Los pasamanos se encuentran en ambos lados de la rampa El edificio tiene una entrada ldquoaccesiblerdquo La abertura de las puertas es suficientemente ancha como para permitir el acceso de una silla de ruedas o un scooter y tienen agarraderas que son faacuteciles de usar

IB = Interior del Edificio (Interior Building) Los pasillos son lo suficientemente anchos como para una silla de ruedas o un scooter Las escaleras si las hay tienen pasamanos Si hay ascensor puede usarse en todo momento en que el edificio esteacute abierto El ascensor tiene sonidos faacuteciles de oiacuter y botones Braille al alcance El ascensor tiene espacio suficiente como para que una persona en silla de ruedas o scooter se deacute vuelta Si hay ascensor con plataforma se puede usar sin ayuda

R = Bantildeo (Restroom) Las puertas del bantildeo son lo suficientemente anchas como para una silla de ruedas o un scooter El bantildeo tiene suficiente espacio para que una persona en silla de ruedas o scooter se deacute vuelta y cierre la puerta Hay pasamanos que permiten trasladarse faacutecilmente de la silla de ruedas al inodoro Es faacutecil llegar al lavamanos y las llaves jaboacuten y papel higieacutenico son faacuteciles de alcanzar y usar

E = Sala de Examen (Exam Room) La abertura de las puertas que llevan hacia las salas de examen son lo suficientemente anchas como para una silla de ruedas o un scooter La sala de examen tiene suficiente espacio como para que una persona en silla de ruedas o scooter se deacute vuelta

T = Camilla de ExamenBaacutescula (Exam TableScale) La camilla de examen se mueve hacia arriba y hacia abajo y tiene espacio a un lado como para una silla de ruedas o scooter Los pacientes en sillas de ruedas o scooters pueden usar la baacutescula

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 16 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Timely Access to Care

This table shows you the how long it should take you to get an appointment with a PHC provider If it takes you longer to get an appointment you can call us at (800) 863-4155 for assistance If you need care outside the normal office hours you can call the Advice Nurse at no cost to you The Advice Nurse line is available 7 days a week 24 hours a day at (866) 778-8873 TTY users call (800) 735-2929 or 711

Appointment Type Must Get Appointment Within

Urgent care appointments that do not require pre-approval (prior authorization)

48 hours

Urgent care appointment that do require prior authorization

96 hours

Non-urgent primary care appointments 10 business days

Non-urgent specialist 15 business days

Non-urgent mental health provider (non-physician)

10 business days

Non-urgent appointment for ancillary services for the diagnosis or treatment of injury illness or other health condition

15 business days

Telephone wait times during normal business hours

10 minutes

Triage ndash 247 services 247 services ndash No more than 30 minutes

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 17 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Acceso oportuno a la atencioacuten meacutedica

Esta tabla le muestra queacute tanto tiempo deberiacutea tomarle obtener una cita con un proveedor de PHC Si llega a tomar maacutes tiempo puede comunicarse con nosotros al (800) 863-4155 para solicitar asistencia Si necesita atencioacuten meacutedica fuera del horario normal del consultorio puede llamar a la enfermera de asesoriacutea sin costo alguno para usted La liacutenea de asesoriacutea de enfermeras estaacute disponible los 7 diacuteas a la semana las 24 horas al diacutea al (866) 778-8873 los usuarios de TTY deben llamar al (800) 735-2929 o marcar 711

Tipo de cita Debe obtener la cita dentro de

Citas de atencioacuten de urgencia que no requieren aprobacioacuten previa (autorizacioacuten previa)

48 horas

Cita de atencioacuten de urgencia que requieren autorizacioacuten previa

96 horas

Citas de atencioacuten meacutedica primaria no urgentes

10 diacuteas laborales

Especialista no urgente 15 diacuteas laborales

Proveedor de salud mental no urgente (profesional de la salud no meacutedico)

10 diacuteas laborales

Cita no urgente para servicios auxiliares para el diagnoacutestico o tratamiento de una lesioacuten enfermedad u otra afeccioacuten de salud

15 diacuteas laborales

Tiempos de espera al teleacutefono durante el horario normal de trabajo

10 minutos

Triaje - servicios 247 Servicios las 24 horas del diacutea los 7 diacuteas de la semana ndash No maacutes de 30 minutos

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 18 of 41

PHC PROVIDERS | SHASTA COUNTY DIRECTORY

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

Physician Listing Information

To report a potential error in the Provider Directory - Email PHCDirectorypartnershiphporg or call (800) 863-4155

How to read the Provider Directory To help you in your selection the following information is provided about each personal physician

Como leer el Directorio de Proveedores Para ayudarle a seleccioacutenar un proveedor lea la informacioacuten siguiente sobre cada proveedor

City Location or Specialty Type Fairfield Ubicacioacuten de Ciudad o Tipo de Especialidad

Provider Site Name Family Medical Center Nombre del Sitio del Proveedor

PCP Site Number PCP 1234-0001 Nuacutemero de Sitio del PCP

Enrollment Status Open to New Patients Estado de Inscribirse

Ages Accepted Ages No Age Limitations Las Edades Aceptadas

Hospital Affiliation Hospital(s) NorthBay Afiliacioacuten de Hospital

Address 1234 Hospital Drive

Fairfield CA 94534

Direccioacuten

Accessibility P EB IB R E T Accesibilidad

Phone (707) 555-5555 (phn) Teleacutefono

Fax (707) 555-5556 (fax) Fax

URL Website wwwabc123com URL Sitio Web

Hours Mon ndash Fri 8 am ndash 6 pm Horas

Medical Specialty Family Practice Especialidad Meacutedica

Providerrsquos Name diams Doe John MD Nombre del Proveedor Meacutedico

NPI 1234567890 NPI

License Number A12345 Nuacutemero de Licencia

Languages Spanish Tagalog Idiomas

Special Accommodations and Levels of Access

Adj Exam Tables

Special Scales for Wheelchairs

Scales that weigh up to 300lbs

Hoyer Lift

Gurney Accommodations

Hearing Impaired Accommodations

Onsite Interpretation Services

Basic Access

Alojamiento Especial y

Niveles de Acceso

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 19 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Anderson

Anderson Family Health Center ^1^

Shasta Community Health CenterPCP PHC 17323-0004

NPI 1942225719FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

2801 Silver StAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 378-0486Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineDavainis Paul C MD ^2^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical Center

Williams Helen Y NP ^3^

NPI 1740626472License 23012Gender FemaleTagalog Visayan

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Anderson Medical Associates ^4^

PCP PHC 27952-0001

NPI 1851373534RHCFamily MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2830 East StAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-2545Primary Fax (530) 365-3871Mon - Thu 730 AM - 430 PMFri 730 AM - 330 PM

Family MedicineMehton Nirmal S MD ^5^

NPI 1851373534License A54327Gender MaleHindi Punjabi UrduHospital Privileges Shasta Regional Medical Center

Ault Susan Rae NP ^6^

NPI 1790777100License 14768Gender Female

Special Accommodations Adj Exam Tables Scales that weigh up to 350lbs

Anderson Walk In Medical Clinic ^7^

PCP PHC 17977-0004

NPI 1275685414RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 530 PMSat Sun 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^8^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Henn Lisa A PA ^9^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^10^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^11^

NPI 1962485839License 13779Gender FemaleSimard Jane K PA-C ^12^

NPI 1245240118License 15925Gender Female

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 20 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Souter Stacia E FNP ^13^

NPI 1972828515License 16856Gender FemaleStanley Jeremiah E FNP ^14^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Happy Valley Health Center ^15^

Shasta Community Health CenterPCP PHC 17289-0005

NPI 1013931476FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

16300 Cloverdale RdAnderson CA 96007 PEBIBE

Level of Access LimitedPrimary Phone (530) 357-2860Primary Fax (530) 245-9985wwwshastahealthorgTue - Thu 800 AM - 500 PM

Schock Julie A FNP ^16^

NPI 1043332521License 14660Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 1000lbs

Burney

Burney Health Center ^17^

Mountain Valleys Health CentersPCP PHC 27934-0001

NPI 1245301308FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

37491 Enterprise DrBurney CA 96013 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 335-5457Primary Fax (530) 335-3060wwwmtnvalleyhcorgMon Wed - Fri 800 AM - 500 PMTue 800 AM - 900 PM

Family MedicineWatson Thomas D MD ^18^

diams Family MedicineNPI 1942235676License G54134Gender MaleSpanishHospital Privileges Mayers Memorial Hospital

Internal MedicineSmith-Chase Latisha A MD ^19^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^20^

NPI 1548577489License 21134Gender FemaleKhan Matthew P FNP ^21^

NPI 1942456124License 17838Gender MaleMacDonald Margaret Ann NP ^22^

NPI 1255850640License 95007356Gender FemaleRoseland Jr Warren Thomas FNP ^23^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^24^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 21 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pit River Health Service Inc ^25^

PCP PHC 24146-0011

NPI 1891762985RHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

36977 Park AveBurney CA 96013 PEBIBRE

Level of Access BasicPrimary Phone (530) 335-3651Primary Fax (530) 335-5064Mon - Fri 800 AM - 500 PM

Family MedicineHason Michael J MD ^26^

NPI 1942241468License G86338Gender Male

Brunet Lynn E PA-C ^27^

NPI 1871650259License 14933Gender FemaleFurber Jr Lewis E NP ^28^

NPI 1013943620License 14945Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Cottonwood

Lassen Medical Clinic-Cottonwood ^29^

Dignity HealthPCP PHC 39300-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

20833 Long Branch DrCottonwood CA 96022 PEBIBRE

Level of Access BasicPrimary Phone (530) 347-3418Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 500 PM

Family MedicineFish Larry William DO ^30^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender Male

Internal MedicineDahnke David G MD ^31^

NPI 1053451625License G80673Gender Male

PediatricsQuintal Patrick L MD ^32^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community HospitalVolquartsen Dale A MD ^33^

diams PediatricsNPI 1841250594License G132571Gender MaleHospital Privileges St Elizabeth Community HospitalWirthlin Laurie Sue MD ^34^

NPI 1174612550License C53534Gender Female

Anjola Laura J NP ^35^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^36^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^37^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^38^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^39^

NPI 1528501038License 53999Gender Female

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 22 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Jesrani Lena B FNP ^40^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^41^

NPI 1972692861License 53790Gender MaleVelasquez Hickerson Ana M PA ^42^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^43^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Fall River Mills

Fall River Valley Health Center ^44^

Mountain Valleys Health CenterPCP PHC 22704-0004

NPI 1922179498FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

43563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-6535Primary Fax (530) 335-5166wwwmtnvalleyhcorgMon - Fri 800 AM - 500 PMSat 800 AM - 100 PM

Family MedicineDahle Daniel B MD ^45^

NPI 1497797906License G53557Gender MaleHospital Privileges Mayers Memorial HospitalNix Tawana N DO ^46^

diams Internal Use Only - Do not assign to providers

NPI 1649324294License 20A9774Gender Female

Internal MedicineSmith-Chase Latisha A MD ^47^

diams Internal Medicinediams Undersea amp Hyperbaric Medicine -

Preventive MedicineNPI 1154349900License G57131Gender FemaleHospital Privileges Mayers Memorial Hospital

Corr Heather Marie PA ^48^

NPI 1548577489License 21134Gender FemaleHanson Sharon A NP ^49^

NPI 1780725226License 16178Gender FemaleMacDonald Margaret Ann NP ^50^

NPI 1255850640License 95007356Gender Female

Roseland Jr Warren Thomas FNP ^51^

NPI 1831183326License 9245Gender MaleTurner Beckie Louise FNP ^52^

NPI 1881835122License 95002248Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 500lbs

Palo Cedro

Anderson Walk In Medical Clinic-Palo Cedro ^53^

PCP PHC 37506-0004

NPI 1770993370Family MedicineAccepting New Patients

19 Years and Older

9461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110wwwandersonwalkinmedicalcliniccomMon - Fri 800 AM - 500 PM

Family MedicineSwenson Rodney M DO ^54^

diams Family MedicineNPI 1407863913License 20A5484Gender Male

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 23 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Henn Lisa A PA ^55^

NPI 1649239690License PA10859Gender FemaleHougland Cheri Elizabeth PA ^56^

NPI 1851551634License 15953Gender FemaleReguera Tiffany L NP ^57^

NPI 1962485839License 13779Gender FemaleStanley Jeremiah E FNP ^58^

NPI 1649508763License 19056Gender MaleSpanish

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Red Bluff

Lassen Medical Clinic-Red Bluff ^59^

Dignity HealthPCP PHC 39299-0004

NPI 1063496651RHCFamily Medicine Internal Medicine PediatricsAccepting Existing Patients

No Age LimitationsCHDP Provider

2450 Sister Mary Columba DrRed Bluff CA 96080 PEBIBRE

Level of Access Basic

Primary Phone (530) 527-0414Primary Fax (530) 528-4423wwwlassenmedicalcomMon - Fri 800 AM - 600 PMSat 800 AM - 500 PM

Family MedicineAggarwal Shruti MD ^60^

diams Family MedicineNPI 1902003734License C134645Gender FemaleHospital Privileges St Elizabeth Community HospitalFish Larry William DO ^61^

diams Family Medicinediams Neuromusculoskeletal Medicine amp

Osteopathic Manipulative Medicine

NPI 1356476568License 20A6448Gender MaleMcDaniel Dan E MD ^62^

diams Family MedicineNPI 1861527459License A22149Gender MaleHospital Privileges St Elizabeth Community HospitalVillapena-Cid Geraldine D MD ^63^

diams Family MedicineNPI 1457576399License A106838Gender FemaleFilipinoHospital Privileges St Elizabeth Community Hospital

Internal MedicineAhmadpour Saeid MD ^64^

diams Internal MedicineNPI 1295715340License C51678Gender MaleHospital Privileges St Elizabeth Community HospitalDahnke David G MD ^65^

NPI 1053451625License G80673Gender MaleSaini Ankur MD ^66^

diams Internal MedicineNPI 1144529397License A124281Gender MaleHindi PunjabiHospital Privileges St Elizabeth Community HospitalSaini Minky MD ^67^

diams Internal MedicineNPI 1700165099License A129753Gender FemaleHindi PunjabiHospital Privileges St Elizabeth Community Hospital

PediatricsFrantz Kimberli R MD ^68^

NPI 1104966787License G69966Gender FemaleSpanishHospital Privileges St Elizabeth Community HospitalKim Kisung MD ^69^

NPI 1073939815License A141207Gender Male

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 24 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Nanjireddy Priyanka M MD ^70^

NPI 1811243041License A144022Gender FemaleHindi Kannada Tamil TeluguHospital Privileges St Elizabeth Community HospitalQuintal Patrick L MD ^71^

diams PediatricsNPI 1962537555License A50886Gender MaleHospital Privileges St Elizabeth Community Hospital

Anjola Laura J NP ^72^

NPI 1487849048License 17295Gender FemaleBeeman Natalie PA ^73^

NPI 1710175930License PA17414Gender FemaleCarr Laura PA-C ^74^

NPI 1699827709License PA16146Gender FemaleCharlesworth Julia R NP ^75^

NPI 1780953273License 6539Gender FemaleHutchinson Rebecca A PA-C ^76^

NPI 1528501038License 53999Gender FemaleJesrani Lena B FNP ^77^

NPI 1083934855License 19382Gender FemaleOakes Dennis E PA-C ^78^

NPI 1972692861License 53790Gender Male

Velasquez Hickerson Ana M PA ^79^

NPI 1912250614License PA22493Gender FemaleVenable Lori PA ^80^

NPI 1790976025License PA14044Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Redding

Churn Creek Healthcare ^81^

Redding RancheriaPCP PHC 35929-0013

NPI 1164807533Family MedicineAccepting New Patients

No Age LimitationsCHDP Provider

3184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327wwwchurncreekhealthcarecomMon - Fri 700 AM - 600 PMSat Sun 900 AM - 800 PM

Family MedicineDavis Paul R DO ^82^

diams Family MedicineNPI 1609989532License 20A7013Gender MaleHospital Privileges Shasta Regional Medical CenterKingsley Jolene A DO ^83^

diams Family MedicineNPI 1639195837License 20A7894Gender FemaleHospital Privileges Mercy Medical Center-ReddingKingsley Michael C DO ^84^

diams Family MedicineNPI 1427078393License 20A7895Gender MaleHospital Privileges Mercy Medical Center-ReddingKristoffersen Sahaile A DO ^85^

diams Family MedicineNPI 1265443972License 20A9009Gender FemaleMorgan Elizabeth H MD ^86^

NPI 1386026466License A145292Gender Female

Egolf John D NP ^87^

NPI 1891991923License 17449Gender MaleHering Kelly Jean FNP ^88^

NPI 1124131883License 9446Gender Female

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 25 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Pelayo Terry L PA-C ^89^

NPI 1326482068License 22947Gender MalePlanchard Sarah L PA-C ^90^

NPI 1942522495License 20841Gender FemaleRoss Summer Lynn PA-C ^91^

NPI 1699897165License PA17629Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Dignity Health Medical Group-North State ^92^

PCP PHC 29515-0001

NPI 1912288432Family Medicine Internal MedicineAccepting Existing Patients

19 Years and Older

1755 Court StRedding CA 96001 PEBIBE

Level of Access LimitedPrimary Phone (530) 247-8800Primary Fax (530) 241-1174Mon - Fri 800 AM - 500 PM

Family MedicineArai Norman K MD ^93^

diams Family MedicineNPI 1144248758License G35036Gender MaleHospital Privileges Mercy Medical Center-Redding

Dong Phuc-Son S DO ^94^

NPI 1598077869License 20A12891Gender MaleHospital Privileges Mercy Medical Center-ReddingTaylor Elizabeth A MD ^95^

NPI 1629313374License A144518Gender FemaleTims Allison M DO ^96^

diams Family MedicineNPI 1831445949License 20A15887Gender FemaleVan Mol Andre MD ^97^

diams Family MedicineNPI 1083603203License G62379Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicineNg Sheralene Hock Choo MD ^98^

diams Internal MedicineNPI 1174546840License G72306Gender FemaleCantonese Chinese MandarinHospital Privileges Mercy Medical Center-Redding

Oppezzo Betsy T PA ^99^

NPI 1639463144License 21608Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 440lbs

Hill Country Community Clinic ^100^

PCP PHC 35161-0001

NPI 1407914260FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

317 Lake Blvd Ste ARedding CA 96003 PIBE

Level of Access LimitedPrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 830 AM - 430 PMWed 100 PM - 500 PM

Family MedicineHolscher Donna A MD ^101^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Hernandez Elizabeth C FNP ^102^

NPI 1578842944License 20888Gender FemaleZane Linda J FNP ^103^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 350lbs

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 26 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Mercy Family Practice ^104^

Dignity HealthPCP PHC 27956-0001

NPI 1477671535Family Medicine Internal MedicineAccepting Existing Patients

No Age LimitationsCHDP Provider

2480 Sonoma StRedding CA 96001 PEBIBET

Level of Access LimitedPrimary Phone (530) 225-7800Primary Fax (530) 225-7888Mon - Fri 800 AM - 430 PM

Family MedicineBland Duane D MD ^105^

diams Family MedicineNPI 1336235779License G74030Gender MaleHospital Privileges Mercy Medical Center-ReddingBosworth Jeffrey A MD ^106^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-ReddingCoe John L MD ^107^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-Redding

Evans Clinton E DO ^108^

diams Family MedicineNPI 1235282559License 20A8919Gender MaleHospital Privileges Mercy Medical Center-ReddingHolscher Donna A MD ^109^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-ReddingMc Mullin Douglas B MD ^110^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingRoitman Jay S DO ^111^

diams Family MedicineNPI 1366461220License 20A5805Gender MaleHospital Privileges Mercy Medical Center-Redding

Internal MedicinePerry Nena L MD ^112^

diams Geriatric Medicine - Internal Medicine

diams Internal MedicineNPI 1457447518License G56783Gender FemaleHospital Privileges Mercy Medical Center-Redding

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 500lbs

Open to New Patients by Clinic Approval Only

Shasta Community Health Center ^113^

PCP PHC 27942-0001

NPI 1891710638FQHCFamily Medicine Internal Medicine PediatricsAccepting New Patients

No Age LimitationsCHDP ProviderShasta County Residents Only

1035 Placer StRedding CA 96001 PEBRET

Level of Access LimitedPrimary Phone (530) 246-5710Primary Fax (530) 245-9985wwwshastahealthorgMon - Thu 800 AM - 800 PMFri 800 AM - 500 PMSat 900 AM - 100 PM

Family MedicineBosworth Jeffrey A MD ^114^

diams Family MedicineNPI 1407840895License G77006Gender MaleHospital Privileges Mercy Medical Center-Redding

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 27 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Coe John L MD ^115^

diams Family MedicineNPI 1043304512License G55487Gender MaleHospital Privileges Mercy Medical Center-ReddingDavainis Paul C MD ^116^

diams Family MedicineNPI 1255340568License G80205Gender MaleHospital Privileges Banner Lassen Medical CenterFeatherstone Bryan DO ^117^

diams Family MedicineNPI 1740262047License 20A7016Gender MaleHospital Privileges Mercy Medical Center-ReddingGrover Rhett D DO ^118^

diams Family MedicineNPI 1811041445License 20A9321Gender MaleHospital Privileges Mercy Medical Center-ReddingKnickerbocker Pamela R DO ^119^

diams Family MedicineNPI 1164561353License 20A12777Gender FemaleLupeika Debra L MD ^120^

diams Family MedicineNPI 1780697607License A70796Gender FemaleHospital Privileges Mercy Medical Center-Redding

Lynn Collin W MD ^121^

diams Family MedicineNPI 1083770754License A97231Gender MaleMc Mullin Douglas B MD ^122^

diams Family MedicineNPI 1487681185License G73745Gender MaleGermanHospital Privileges Mercy Medical Center-ReddingMcClean Jill A MD ^123^

diams Family MedicineNPI 1790839355License A97507Gender FemaleHospital Privileges Mercy Medical Center-ReddingMonie Herbert J MD ^124^

NPI 1881679991License A40025Gender MaleMooneyham Amanda Ann MD ^125^

diams Family MedicineNPI 1962709568License A138589Gender FemaleAmerican Sign LanguageHospital Privileges Mercy Medical Center-ReddingNatarajan Nandhini MD ^126^

diams Family MedicineNPI 1730520610License A138925Gender Female

Nicora Bia Maria de Lourdes MD ^127^

diams Family MedicineNPI 1174785489License A108375Gender FemaleSpanishRezai Mohammed T DO ^128^

NPI 1013399195License 20A14895Gender MaleFarsiStanfield Robert J MD ^129^

NPI 1588683247License A35421Gender MaleStockton Candy A MD ^130^

diams Addiction Medicine - Preventive Medicine

diams Family MedicineNPI 1417996240License A89133Gender FemaleTasista Melissa D DO ^131^

diams Family MedicineNPI 1447273974License 20A9025Gender FemaleVillalobos Joe L MD ^132^

diams Family MedicineNPI 1770502445License A80552Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingYoon David W MD ^133^

NPI 1689075582License A142208Gender Male

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 28 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Internal MedicineChoudhry Sara MD ^134^

diams Internal MedicineNPI 1023225521License A103503Gender FemaleHospital Privileges Mercy Medical Center-Redding

PediatricsCarter Kelly Duane MD ^135^

diams PediatricsNPI 1124123195License C54560Gender MaleHospital Privileges St Elizabeth Community HospitalDugan Sean P MD ^136^

diams PediatricsNPI 1871721100License A121229Gender MaleSpanishHospital Privileges Mercy Medical Center-ReddingSaini Deepika MD ^137^

diams PediatricsNPI 1013032762License A102244Gender FemaleHospital Privileges St Elizabeth Community HospitalSand Patricia O MD ^138^

diams PediatricsNPI 1992725873License G61929Gender FemaleVenglarcik Carey A MD ^139^

diams PediatricsNPI 1982963583License A126194Gender Female

Anderson Kristen N PA ^140^

NPI 1962891036License 52159Gender FemaleBratton-Sandoval Dorothy A PA ^141^

NPI 1881873206License 18731Gender FemaleCooper Elisabeth M PA ^142^

NPI 1114969003License 22308Gender FemaleEdwards Elaine I FNP ^143^

NPI 1013377449License 95003815Gender FemaleGamboe Robert W PA ^144^

NPI 1396012654License PA22207Gender MaleMcKoin Kelly M PA-C ^145^

NPI 1316392277License 53228Gender FemaleOppenheim Kathleen F NP ^146^

NPI 1902817661License 8489Gender FemaleRelyea Sandra J PA ^147^

NPI 1962413633License PA12880Gender FemaleSharp Katelyn M NP ^148^

NPI 1205293370License 95003603Gender Female

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shasta Regional Medical Group ^149^

PCP PHC 32497-0004

NPI 1396990545Family MedicineAccepting Existing Patients

19 Years and Older

1355 East St Ste 200Redding CA 96001 PRE

Level of Access LimitedPrimary Phone (530) 605-4260Primary Fax (530) 605-4265wwwshastaregionalmedicalgroupcomMon - Fri 800 AM - 500 PM

Family MedicineDillon Cynthia R MD ^150^

NPI 1619977527License G79019Gender FemaleSpanishHospital Privileges Shasta Regional Medical CenterMartinez Richard A MD ^151^

diams Family MedicineNPI 1578615647License G62068Gender MaleSpanishHospital Privileges Shasta Regional Medical Center

Bainbridge Troy Michael PA ^152^

NPI 1942402847License 19905Gender Male

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 29 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Round Mountain

Hill Country Community Clinic ^153^

PCP PHC 27936-0001

NPI 1407914260FQHCFamily Medicine Internal MedicineAccepting New Patients

No Age LimitationsCHDP Provider

29632 Hwy 299 ERound Mountain CA 96084 PEBIBRE

Level of Access BasicSkilled Medical Interpreter ServicePrimary Phone (530) 337-6243Primary Fax (530) 337-6655wwwhillcountryclinicorgMon Tue Thu Fri 900 AM - 500 PMWed 945 AM - 500 PM

Family MedicineFranchuk Jennifer A MD ^154^

NPI 1639446099License C137951Gender FemaleHolscher Donna A MD ^155^

diams Family MedicineNPI 1306971148License G59568Gender FemaleSpanishHospital Privileges Mercy Medical Center-Redding

Internal MedicineBalcazar Mirtha Luz MD ^156^

NPI 1174515969License A44843Gender FemaleHospital Privileges Mercy Medical Center-Redding

Anderson Nathanial R PA ^157^

NPI 1376731570License 53324Gender MaleBennett Laurel E FNP ^158^

NPI 1033639661License 818034Gender FemaleFoster Susan Elizabeth NP ^159^

NPI 1982986170License 20841Gender FemaleHusome Darra Ann NP ^160^

NPI 1952444986License 9880Gender FemaleOxenford Evelyn K FNP ^161^

NPI 1457544249License 95007465Gender FemaleRotin Christine R PA-C ^162^

NPI 1417098138License 18517Gender FemaleZane Linda J FNP ^163^

NPI 1770906067License 95000360Gender Female

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 750lbs

Shasta Lake

Harold S Budhram MD Inc ^164^

PCP PHC 27260-0004

NPI 1346572468RHCFamily MedicineAccepting Existing Patients

19 Years and Older

5145 Shasta Dam BlvdShasta Lake CA 96019 Level of Access LimitedPrimary Phone (530) 275-5421Primary Fax (530) 275-1549Mon - Thu 900 AM - 500 PM

Family MedicineBudhram Harold S MD ^165^

NPI 1871518761License G31973Gender Male

Robinson Mark William NP ^166^

NPI 1235388232License 4011Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Scales that weigh up to 400lbs

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 30 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PRIMARY CARE PROVIDERS

SHASTA COUNTY DIRECTORY

Shasta Lake Family Health ^167^

Shasta Community Health CenterPCP PHC 27935-0001

NPI 1013932797FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

4215 Front StShasta Lake CA 96019 EBIBE

Level of Access LimitedPrimary Phone (530) 276-9168Primary Fax (530) 245-9985wwwshastahealthorgMon - Fri 800 AM - 500 PM

Family MedicineFreeberg Adam M DO ^168^

NPI 1891137998License 20A13634Gender MaleSpanishLode George J MD ^169^

NPI 1710958285License C42781Gender MalePorter Elaine M MD ^170^

diams Family MedicineNPI 1972522613License A61020Gender FemaleGerman

Botcharnikova Larissa N PA ^171^

NPI 1720122054License PA17636Gender FemaleRussian

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Medical Equipment Access Scales that weigh up to 1000lbs

Shingletown

Shingletown Medical Center ^172^

PCP PHC 27946-0001

NPI 1750387072FQHCFamily MedicineAccepting New Patients

No Age LimitationsCHDP Provider

31292 Alpine Meadows RdShingletown CA 96088 PEBIBE

Level of Access LimitedPrimary Phone (530) 474-3390Primary Fax (530) 474-4899wwwshingletownmedcenterorgMon Wed - Fri 900 AM - 530 PMTue 930 AM - 530 PM

Family MedicineAustin Jeremy R MD ^173^

diams Family MedicineNPI 1104849140License A74451Gender Male

Doolin Shana Renee FNP ^174^

NPI 1811138712License 16037Gender FemaleOtt Jeffrey A FNP ^175^

NPI 1447506472License 21953Gender Male

Simpson Michael Ward NP ^176^

NPI 1801978861License 5849Gender Male

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 500lbs

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 31 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Hospitals Primary

Mayers Memorial Hospital ^177^

PHC 4317

NPI 1912125667License 23000002143563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter ServicePrimary Phone (530) 336-5511Primary Fax (530) 336-6199wwwmayersmemorialcom24 Hours 7 Days a Week

Mercy Medical Center - Redding ^178^

PHC 2454

NPI 1477671535License 2300000242175 Rosaline AveRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 225-6000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Shasta Regional Medical Center ^179^

PHC 19757

NPI 1205089026License 2300000231100 Butte StRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 244-5400Primary Fax (530) 244-5364wwwshastaregionalcom24 Hours 7 Days a Week

Vibra Hospital of Northern California ^180^

PHC 28146

NPI 1972580363License 2300001912801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-4204wwwvhnorcalcom24 Hours 7 Days a Week

Hospitals Referral

CPMC-California Campus ^181^

PHC 1646

NPI 1740348929License 2200001973700 California StSan Francisco CA 94118 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (415) 369-131124 Hours 7 Days a Week

CPMC-Davies Campus ^182^

PHC 3969

NPI 1265590442License 220000197601 Duboce Ave Castro St amp Duboce AveSan Francisco CA 94117 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-Pacific Campus ^183^

PHC 1646

NPI 1740348929License 2200001972333 Buchanan StSan Francisco CA 94115 Skilled Medical Interpreter ServicePrimary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

CPMC-St Lukes Campus ^184^

PHC 1872

NPI 1881712933License 2200000703555 Cesar ChavezSan Francisco CA 94110 Primary Phone (415) 600-6000Primary Fax (714) 783-254824 Hours 7 Days a Week

Childrens Hospital Oakland ^185^

PHC 1560

NPI 1003961251License 140000015747 52nd StOakland CA 94609 Skilled Medical Interpreter ServicePrimary Phone (510) 428-3000wwwchildrenshospitaloaklandorg24 Hours 7 Days a Week

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 32 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Feather River Hospital ^186^

PHC 2446

NPI 1518940667License 2300000175974 Pentz RdParadise CA 95969 Skilled Medical Interpreter ServicePrimary Phone (530) 877-9361wwwadventisthealthorg

feather-river24 Hours 7 Days a Week

John Muir Medical Center-Concord Campus ^187^

PHC 1559

NPI 1801821376License 1400001282540 East StConcord CA 94520 Skilled Medical Interpreter ServicePrimary Phone (925) 682-8200wwwjohnmuirhealthcom24 Hours 7 Days a Week

Lodi Memorial Hospital ^188^

PHC 1379

NPI 1316938301License 030000056975 South Fairmont AveLodi CA 95240 Skilled Medical Interpreter ServicePrimary Phone (209) 334-3411Primary Fax (209) 333-3160wwwadventisthealthorg

lodimemorial24 Hours 7 Days a Week

Mercy General Hospital ^189^

PHC 2027

NPI 1487694857License 0300000624001 J StSacramento CA 95819 Skilled Medical Interpreter ServicePrimary Phone (916) 453-4545wwwdignityhealthorg24 Hours 7 Days a Week

Mercy Hospital of Folsom ^190^

PHC 1733

NPI 1356389878License 0300003721650 Creekside DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 983-7400wwwdignityhealthorg24 Hours 7 Days a Week

Mercy San Juan Hospital ^191^

PHC 2026

NPI 1972541498License 0300000636501 Coyle AveCarmichael CA 95608 Skilled Medical Interpreter ServicePrimary Phone (916) 537-5000wwwdignityhealthorg24 Hours 7 Days a Week

Methodist Hospital of Sacramento

^192^

PHC 2029

NPI 1467560599License 0300000647500 Hospital DrSacramento CA 95823 Skilled Medical Interpreter ServicePrimary Phone (916) 423-3000wwwdignityhealthorg24 Hours 7 Days a Week

Shriners Hospitals for Children ^193^

PHC 24564

NPI 1962530451License 0300006202425 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 453-2000Primary Fax (916) 453-2388wwwshrinershospitalsforchildrenorg24 Hours 7 Days a Week

St Elizabeth Community Hospital ^194^

PHC 5072

NPI 1083732853License 2300000362550 Sister Mary Columba DrRed Bluff CA 96080 Skilled Medical Interpreter ServicePrimary Phone (530) 529-8000Primary Fax (530) 225-6335wwwdignityhealthorg24 Hours 7 Days a Week

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 33 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Sutter Medical Center Sacramento ^195^

PHC 1933

NPI 1811946734License 0300001022825 Capitol AveSacramento CA 95816 Skilled Medical Interpreter ServicePrimary Phone (916) 887-0000Primary Fax (916) 733-105824 Hours 7 Days a Week

UC Davis Medical Center ^196^

PHC 2302

NPI 1710918545License 0300000862315 Stockton BlvdSacramento CA 95817 Skilled Medical Interpreter ServicePrimary Phone (916) 734-2011Patient Referral Phone 800-482-3284wwwucdmcucdavisedu

medicalcenter24 Hours 7 Days a Week

UCSF Medical Center ^197^

PHC 1555

NPI 1083713788License 220000091505 Parnassus AveSan Francisco CA 94143 Skilled Medical Interpreter ServicePrimary Phone (415) 476-1000Patient Referral Phone 800-444-2559Primary Fax (415) 353-1818wwwucsfhealthorg24 Hours 7 Days a Week

Vibra Hospital of Sacramento ^198^

PHC 29489

NPI 1134564693License 030000377330 Montrose DrFolsom CA 95630 Skilled Medical Interpreter ServicePrimary Phone (916) 351-9151Primary Fax (916) 984-7859wwwvhsacramentocom24 Hours 7 Days a Week

Zuckerberg San Francisco General Hospital ^199^

PHC 1558

NPI 1164609962License 2200000631001 Potrero AveSan Francisco CA 94110 Skilled Medical Interpreter ServicePrimary Phone (415) 206-8000wwwzsfgcareorg24 Hours 7 Days a Week

Mental Health Services - Outpatient

Beacon Health Strategies ^200^

Call Beacon Health Strategies to request information on available mental health providers or for general questions about mental health services You can also visit Beacons website and type the word partnership on the member login pagePrimary Phone (855) 765-9703wwwbeaconhealthstrategiescom

member_loginaspx

You may email Beacon Member Services at MemberServicebeaconhscom

Pharmacy Network List

COSTCO PHARMACY ^201^

NPI 16594812571300 DANA DRIVEREDDING CA 96003 Primary Phone (530) 222-8097Primary Fax (530) 222-8081Mon - Fri 1000 AM - 700 PMSat 1000 AM - 600 PM

COTTONWOOD DRUGS ^202^

NPI 111497479720635 GAS POINT RDCOTTONWOOD CA 96022 Primary Phone (530) 347-3721Primary Fax (530) 803-2006Mon - Fri 900 AM - 600 PMSat 1000 AM - 200 PM

CVS PHARMACY ^203^

NPI 15785053841060 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 221-5575Primary Fax (530) 221-5317Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 600 PM

CVS PHARMACY ^204^

NPI 15987088513375 PLACER STREDDING CA 96001

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 34 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 241-7328Primary Fax (530) 241-7605Mon - Fri 800 AM - 900 PMSat Sun 900 AM - 500 PM

CVS PHARMACY ^205^

NPI 10634347511280 DANA DRREDDING CA 96003 Primary Phone (530) 224-1437Primary Fax (530) 646-3323Mon - Fri 900 AM - 700 PMSat 900 AM - 500 PMSun 1100 AM - 500 PM

CWD CLOSED DOOR ^206^

NPI 154835718920633 GAS POINT DRCOTTONWOOD CA 96022 Primary Phone (530) 347-4288Primary Fax (530) 347-9658Mon - Fri 900 AM - 530 PMSat 1000 AM - 230 PM

FERRYS PHARMACY INC ^207^

NPI 14978569342940 EAST STANDERSON CA 96007 Primary Phone (530) 365-3388Primary Fax (530) 365-2443Mon - Fri 900 AM - 600 PMSat 900 AM - 500 PM

LIMS FAMILY PHARMACY INC ^208^

NPI 14170343801035 PLACER ST STE 110REDDING CA 96001

Primary Phone (530) 241-8700Primary Fax (530) 241-8889Mon - Thu 900 AM - 730 PMFri 900 AM - 600 PMSat 900 AM - 100 PM

MAYERS MEMORIAL HOSPITAL DISTRICT ^209^

NPI 126564615243563 STATE HWY 299 EFALL RIVER MILLS CA 96028 Primary Phone (530) 336-5511Primary Fax (530) 336-6201Mon - Fri 700 AM - 330 PM

OWENS HEALTHCARE 1 ^210^

NPI 14674045662025 COURT ST STE AREDDING CA 96001 Primary Phone (530) 243-4336Primary Fax (530) 243-0301Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 17 ^211^

NPI 1891066775317 LAKE BLVD STE BREDDING CA 96003 Primary Phone (530) 351-7050Primary Fax (530) 351-7055Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 2 ^212^

NPI 18019474032880 CHURN CREEK RD STE AREDDING CA 96002

Primary Phone (530) 226-5530Primary Fax (530) 226-5540Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 3 ^213^

NPI 16199202872975 EAST STANDERSON CA 96007 Primary Phone (530) 365-2778Primary Fax (530) 365-0132Mon - Thu 900 AM - 600 PMFri 900 AM - 700 PMSat 900 AM - 100 PM

OWENS HEALTHCARE 6 ^214^

NPI 12657643931002 PLACER STREDDING CA 96001 Primary Phone (530) 244-8600Primary Fax (530) 244-8605Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 8 ^215^

NPI 18412454122025 COURT ST STE BREDDING CA 96001 Primary Phone (530) 244-8669Primary Fax (530) 243-0687Mon - Fri 900 AM - 600 PM

OWENS HEALTHCARE 9 ^216^

NPI 11846765952025 COURT ST STE DREDDING CA 96001 Primary Phone (530) 225-8898Primary Fax (530) 246-7366Mon - Fri 830 AM - 530 PM

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 35 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

OWENS PHARMACY 21 ^217^

NPI 19123952299387 DESCHUTES RD STE 1PALO CEDRO CA 96073 Primary Phone (530) 547-0936Primary Fax (530) 547-0935Mon - Fri 900 AM - 600 PMSat 900 AM - 100 PM

OWENS PHARMACY 26 ^218^

NPI 16092309942025 COURT STREET SUITE EREDDDING CA 96001 Primary Phone (530) 241-3550Primary Fax (530) 241-3605Mon - Fri 900 AM - 600 PM

RALEYS PHARMACY 248 ^219^

NPI 1073623740201 LAKE BLVD UNIT BREDDING CA 96003 Primary Phone (530) 246-3511Primary Fax (530) 246-2672Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 530 PM

REDDING RANCHERIA INDIAN HEALTH SVCS ^220^

NPI 15281022821441 LIBERTY STREDDING CA 96001 Primary Phone (530) 224-2700Primary Fax (530) 224-2726Mon - Fri 830 AM - 530 PM

REDDING VA CBOC PHARMACY ^221^

NPI 1750349056351 HARTNELL AVEREDDING CA 96002 Primary Phone (530) 226-7555Primary Fax (530) 226-7505Mon - Fri 800 AM - 500 PM

RITE AID PHARMACY 06095 ^222^

NPI 11745452066424 WESTSIDE ROADREDDING CA 96001 Primary Phone (530) 243-3616Primary Fax (530) 243-0981Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06097 ^223^

NPI 13362591671801 EUREKA WAYREDDING CA 96001 Primary Phone (530) 243-5500Primary Fax (530) 243-2437Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06099 ^224^

NPI 1912016379975 EAST CYPRESS AVENUEREDDING CA 96002 Primary Phone (530) 223-3995Primary Fax (530) 223-4613Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06100 ^225^

NPI 18716022763095 MCMURRAY DRIVEANDERSON CA 96007 Primary Phone (530) 365-5753Primary Fax (530) 365-4408Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06101 ^226^

NPI 121504662837435 MAIN STREETBURNEY CA 96013 Primary Phone (530) 335-4860Primary Fax (530) 335-3655Mon - Fri 800 AM - 800 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06480 ^227^

NPI 15584708985350 SHASTA DAM BOULEVARDSHASTA LAKE CA 96019 Primary Phone (530) 275-1532Primary Fax (530) 275-4199Mon - Fri 800 AM - 1000 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

RITE AID PHARMACY 06714 ^228^

NPI 13264477079340 DESCHUTES RDPALO CEDRO CA 96073

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 36 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Primary Phone (530) 547-4403Primary Fax (530) 547-4845Mon - Fri 900 AM - 900 PMSat 900 AM - 500 PMSun 1000 AM - 600 PM

SAFEWAY PHARMACY 0273 ^229^

NPI 18614218102601 BALLS FERRY RDANDERSON CA 96007 Primary Phone (530) 365-1010Primary Fax (530) 365-2937Mon - Fri 800 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1826 ^230^

NPI 11442591851070 E CYPRESS AVEREDDING CA 96002 Primary Phone (530) 222-8274Primary Fax (530) 222-6384Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 1954 ^231^

NPI 17008157272275 PINE STREDDING CA 96001 Primary Phone (530) 247-3040Primary Fax (530) 247-3044Mon - Fri 900 AM - 800 PMSat Sun 900 AM - 500 PM

SAFEWAY PHARMACY 4178 ^232^

NPI 135638799737264 MAIN STBURNEY CA 96013

Primary Phone (530) 335-4101Primary Fax (530) 335-4151Mon - Fri 900 AM - 700 PMSat Sun 900 AM - 500 PM

SHOPKO PHARMACY ^233^

NPI 165931610755 LAKE BLVDREDDING CA 96003 Primary Phone (530) 241-0713Primary Fax (530) 241-1447Mon - Fri 900 AM - 700 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^234^

NPI 1528073533115 LAKE BLVD EASTREDDING CA 96003 Primary Phone (530) 229-1519Primary Fax (530) 229-1522Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALGREENS ^235^

NPI 18816091131775 EUREKA WAYREDDING CA 96001 Primary Phone (530) 241-3294Primary Fax (530) 241-7262Mon - Fri 800 AM - 900 PMSat 900 AM - 600 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-2537 ^236^

NPI 16795909131515 DANA DRIVEREDDING CA 96003 Primary Phone (530) 221-3166Primary Fax (530) 221-3202Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

WALMART PHARMACY 10-5133 ^237^

NPI 17604249075000 RHONDA ROADANDERSON CA 96007 Primary Phone (530) 378-1680Primary Fax (530) 378-2077Mon - Fri 800 AM - 900 PMSat 900 AM - 700 PMSun 1000 AM - 600 PM

Skilled Nursing Long Term Care Facilities

Copper Ridge Care Center ^238^

PHC 11114

NPI 1952465791201 Hartnell AveRedding CA 96002 Primary Phone (530) 222-2273Primary Fax (530) 222-012924 Hours 7 Days a Week

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 37 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Crestwood Wellness and Recovery Center ^239^

PHC 28376

NPI 11947430883062 Churn Creek RdRedding CA 96002 Primary Phone (530) 221-0976Primary Fax (530) 223-392324 Hours 7 Days a Week

Kindred Transitional Care and Rehabilitation - Canyonwood ^240^

PHC 28962

NPI 18412144422120 Benton DrRedding CA 96003 Primary Phone (530) 243-6317Primary Fax (530) 243-464624 Hours 7 Days a Week

Marquis Care at Shasta ^241^

PHC 28929

NPI 15987503583550 Churn Creek RdRedding CA 96002 Primary Phone (530) 222-3630Primary Fax (530) 222-363824 Hours 7 Days a Week

Mayers Memorial Hospital District

^242^

PHC 4317

NPI 138676345643563 Hwy 299EFall River Mills CA 96028 Skilled Medical Interpreter Service

Primary Phone (530) 336-5511Primary Fax (530) 336-619924 Hours 7 Days a Week

Oak River Rehab ^243^

PHC 25578

NPI 13160052263300 Franklin StAnderson CA 96007 Primary Phone (530) 365-0025Primary Fax (530) 365-921524 Hours 7 Days a Week

Redding Post Acute ^244^

PHC 46176

NPI 11841679911836 Gold StRedding CA 96001Primary Phone (707) 230-8437Primary Fax (530) 241-907724 Hours 7 Days a Week

Vibra Hospital of Northern California ^245^

PHC 28146

NPI 19725803632801 Eureka WayRedding CA 96001 Skilled Medical Interpreter ServicePrimary Phone (530) 246-9000Primary Fax (530) 245-420424 Hours 7 Days a Week

Urgent Care Sites

Anderson Walk In Medical Clinic ^246^

PHC 17977

NPI 12756854143082 McMurray DrAnderson CA 96007 PEBIBRE

Level of Access BasicPrimary Phone (530) 365-4412Primary Fax (530) 365-5186Sat Sun 800 AM - 500 PM

Special Accommodations Adj Exam Tables Hearing Impaired Accommodations Gurney Accommodations Scales that weigh up to 550lbs

Anderson Walk In Medical Clinic-Palo Cedro ^247^

PHC 37506

NPI 17709933709461 Deschutes Rd Ste 4Palo Cedro CA 96073 PEBIBRE

Level of Access BasicPrimary Phone (530) 547-5305Primary Fax (530) 547-4110Mon - Fri 800 AM - 500 PM

Special Accommodations Adj Exam Tables Scales that weigh up to 450lbs

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 38 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Churn Creek Healthcare ^248^

PHC 35929

NPI 11648075333184 Churn Creek RdRedding CA 96002 PIBRET

Level of Access LimitedPrimary Phone (530) 768-2436Primary Fax (530) 221-1327Sat Sun 900 AM - 800 PM

Special Accommodations Adj Exam Tables Gurney Accommodations Scales that weigh up to 450lbs

Vision Service Plan (VSP) (1-800-877-7195)

Anderson Vision Center ^249^

NPI 15189366572890 Ventura StAnderson CA 96007Primary Phone (530) 365-6471Primary Fax (530) 365-3332Mon - Thu 800 AM - 500 PM

Bernet Dan E OD ^250^

NPI 1518936657License 6166Gender Male

Bill V Brown OD ^251^

NPI 148770206443124 State Highway 299 EFall River Mills CA 96028Primary Phone (530) 336-5220Mon 100 AM - 500 PMTue - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Brown Bill V OD ^252^

NPI 1487702064License 8202Gender MaleJapanese

Cooper and Link ODs ^253^

NPI 11544977583241 Churn Creek RdRedding CA 96002Primary Phone (530) 222-2020Primary Fax (530) 222-2078Mon - Fri 830 AM - 500 PM

Cooper Jeffrey B OD ^254^

NPI 1548245467License 7437Gender MaleLink Laureen K OD ^255^

NPI 1801871801License 7261Gender Female

Gary Gallagher OD ^256^

NPI 18110237243080 Victor AveRedding CA 96002Primary Phone (530) 222-3166Primary Fax (530) 222-6539Mon - Thu 800 AM - 500 PMFri 800 AM - 300 PM

Gallagher Gary OD ^257^

NPI 1699740456License 6443Gender Male

Henry D Patterson OD A Prof Opt Corp ^258^

NPI 130610322137333 Highway 299EBurney CA 96013Primary Phone (530) 335-2233Primary Fax (530) 335-3933Mon - Wed 800 AM - 530 PMThu 800 AM - 400 PM

Patterson Henry D OD ^259^

NPI 1164710745License 14348Gender MaleFrench German Portuguese Spanish

Janani K Lannin OD ^260^

NPI 16098109281950 Court StRedding CA 96001Primary Phone (530) 241-0778Primary Fax (530) 243-7013Mon - Fri 830 AM - 530 PM

Lannin Janani K OD ^261^

NPI 1609810928License 7232Gender FemaleHindi

Julie L Gussenhoven OD ^262^

NPI 18816254653416 Bechelli LnRedding CA 96002Primary Phone (530) 222-7290Primary Fax (530) 605-1152Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 39 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC FACILITIES PHARMACY URGENT CARE amp VSP LIST

SHASTA COUNTY DIRECTORY

Gussenhoven Julie L OD ^263^

NPI 1881625465License 11423Gender Female

Kristi K Davis OD Inc ^264^

NPI 11040941272515 Park Marina Dr Ste 201Redding CA 96001Primary Phone (530) 222-7271Primary Fax (530) 222-5282Mon - Thu 800 AM - 500 PMFri 900 AM - 100 PM

Davis Kristi K OD ^265^

NPI 1568420214License 11942Gender FemaleSpanish

Meredith L Turner OD ^266^

NPI 19426509162132 Eureka WayRedding CA 96001Primary Phone (530) 244-4234Primary Fax (530) 244-0465Mon - Thu 800 AM - 500 PMFri 800 AM - 100 PM

Turner Meredith L OD ^267^

NPI 1942650916License 33404Gender FemaleWard Thomas E OD ^268^

NPI 1619020609License 5966Gender Male

Michael K Farrar OD ^269^

NPI 13361343453650 Main St Ste CCottonwood CA 96022Primary Phone (530) 347-7347Primary Fax (530) 347-3958Mon - Thu 900 AM - 500 PMFri 900 AM - 1200 PM

Farrar Michael K OD ^270^

NPI 1336134345License 7107Gender MaleGerman Spanish

Nancy Ekelund OD ^271^

NPI 13264644882620 Larkspur Ln Ste LRedding CA 96002Primary Phone (530) 223-4300Primary Fax (530) 222-8903Mon - Fri 830 AM - 500 PM

Ekelund Nancy C OD ^272^

NPI 1215910641License 7944Gender FemaleSpanish

Palo Cedro Eyecare Optometric ^273^

NPI 19424690289372 Deschutes RdPalo Cedro CA 96073Primary Phone (530) 547-2020Primary Fax (530) 547-2101Mon - Thu 900 AM - 500 PMFri 1100 AM - 300 PM

Feucht Allisyn S OD ^274^

NPI 1750679247License 14232Gender Female

Richard Martin OD ^275^

NPI 17604582692005 Court StreetRedding CA 96001Primary Phone (530) 605-4230Primary Fax (530) 605-4229Mon Wed 830 AM - 430 PMTue Thu 830 AM - 500 PM

Martin Richard A OD ^276^

NPI 1760458269License 8799Gender MaleFrench

Shasta Eye Medical Group Inc ^277^

NPI 13462356033190 Churn Creek RdRedding CA 96002Primary Phone (530) 223-2500Primary Fax (530) 226-1375Mon - Fri 800 AM - 500 PM

Crum Bryan G MD ^278^

NPI 1902891385License G69282Gender MaleChinese French SpanishLin Christopher MD ^279^

NPI 1811982291License G72980Gender MaleSilverstein Bruce E MD ^280^

NPI 1255326476License G76457Gender MaleFrench SpanishTrent Robert G MD ^281^

NPI 1114913761License G86708Gender Male

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 40 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

INDEX

A

Aggarwal Shruti MD 23Ahmadpour Saeid MD 23Anderson 19 20Anderson Kristen N PA 28Anderson Nathanial R PA 29Anjola Laura J NP 21 24Arai Norman K MD 25Ault Susan Rae NP 19Austin Jeremy R MD 30

B

Bainbridge Troy Michael PA 28Balcazar Mirtha Luz MD 29Beeman Natalie PA 21 24Bennett Laurel E FNP 29Bernet Dan E OD 38Bland Duane D MD 26Bosworth Jeffrey A MD 26Botcharnikova Larissa N PA 30Bratton-Sandoval Dorothy A PA 28Brown Bill V OD 38Brunet Lynn E PA-C 21Budhram Harold S MD 29Burney 20 21

C

Carr Laura PA-C 21 24Carter Kelly Duane MD 28Charlesworth Julia R NP 21 24Choudhry Sara MD 28Coe John L MD 26 27Cooper Elisabeth M PA 28Cooper Jeffrey B OD 38Corr Heather Marie PA 20 22Cottonwood 21 22Crum Bryan G MD 39

D

Dahle Daniel B MD 22Dahnke David G MD 21 23Davainis Paul C MD 19 27Davis Kristi K OD 39Davis Paul R DO 24Dillon Cynthia R MD 28Dong Phuc-Son S DO 25Doolin Shana Renee FNP 30Dugan Sean P MD 28

E

Edwards Elaine I FNP 28Egolf John D NP 24

Ekelund Nancy C OD 39Evans Clinton E DO 26

F

Fall River Mills 22Farrar Michael K OD 39Featherstone Bryan DO 27Feucht Allisyn S OD 39Fish Larry William DO 21 23Foster Susan Elizabeth NP 29Franchuk Jennifer A MD 29Frantz Kimberli R MD 23Freeberg Adam M DO 30Furber Jr Lewis E NP 21

G

Gallagher Gary OD 38Gamboe Robert W PA 28Grover Rhett D DO 27Gussenhoven Julie L OD 39

H

Hanson Sharon A NP 22Hason Michael J MD 21Henn Lisa A PA 19 23Hering Kelly Jean FNP 24Hernandez Elizabeth C FNP 25Holscher Donna A MD 25 26 29Hospitals Primary 31Hospitals Referral 31 32 33Hougland Cheri Elizabeth PA 19 23Husome Darra Ann NP 29Hutchinson Rebecca A PA-C 21 24

J

Jesrani Lena B FNP 22 24

K

Khan Matthew P FNP 20Kim Kisung MD 23Kingsley Jolene A DO 24Kingsley Michael C DO 24Knickerbocker Pamela R DO 27Kristoffersen Sahaile A DO 24

L

Lannin Janani K OD 38Lin Christopher MD 39Link Laureen K OD 38Lode George J MD 30

Lupeika Debra L MD 27Lynn Collin W MD 27

M

MacDonald Margaret Ann NP 20 22Martin Richard A OD 39Martinez Richard A MD 28Mc Mullin Douglas B MD 26 27McClean Jill A MD 27McDaniel Dan E MD 23McKoin Kelly M PA-C 28Mehton Nirmal S MD 19Mental Health Services - Outpatient 33Monie Herbert J MD 27Mooneyham Amanda Ann MD 27Morgan Elizabeth H MD 24

N

Nanjireddy Priyanka M MD 24Natarajan Nandhini MD 27Ng Sheralene Hock Choo MD 25Nicora Bia Maria de Lourdes MD 27Nix Tawana N DO 22

O

Oakes Dennis E PA-C 22 24Oppenheim Kathleen F NP 28Oppezzo Betsy T PA 25Ott Jeffrey A FNP 30Oxenford Evelyn K FNP 29

P

Palo Cedro 22 23Patterson Henry D OD 38Pelayo Terry L PA-C 25Perry Nena L MD 26Pharmacy Network List 33 34 35 36Planchard Sarah L PA-C 25Porter Elaine M MD 30

Q

Quintal Patrick L MD 21 24

R

Red Bluff 23 24Redding 24 25 26 27 28Reguera Tiffany L NP 19 23Relyea Sandra J PA 28Rezai Mohammed T DO 27Robinson Mark William NP 29

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Page 41 of 41

To verify the availability of providers call PHC Member Services at (800) 863-4155 TTY Users call (800) 735-2929 or 711diams = Board Certified = Trained in Cultural Competency See Page 14 for a description of codes P EB IB R E T

Revised Date May 25 2018

PHC PROVIDER INDEX | SHASTA COUNTY DIRECTORY

Roitman Jay S DO 26Roseland Jr Warren Thomas FNP 20 22Ross Summer Lynn PA-C 25Rotin Christine R PA-C 29Round Mountain 29

S

Saini Ankur MD 23Saini Deepika MD 28Saini Minky MD 23Sand Patricia O MD 28Schock Julie A FNP 20Sharp Katelyn M NP 28Shasta Lake 29 30Shingletown 30Silverstein Bruce E MD 39Simard Jane K PA-C 19Simpson Michael Ward NP 30Skilled Nursing Long Term Care Facilities 36 37Smith-Chase Latisha A MD 20 22Souter Stacia E FNP 20Stanfield Robert J MD 27Stanley Jeremiah E FNP 20 23Stockton Candy A MD 27Swenson Rodney M DO 19 22

T

Tasista Melissa D DO 27Taylor Elizabeth A MD 25Tims Allison M DO 25Trent Robert G MD 39Turner Beckie Louise FNP 20 22Turner Meredith L OD 39

U

Urgent Care Sites 37 38

V

Van Mol Andre MD 25Velasquez Hickerson Ana M PA 22 24Venable Lori PA 22 24Venglarcik Carey A MD 28Villalobos Joe L MD 27Villapena-Cid Geraldine D MD 23Vision Service Plan (VSP)

(1-800-877-7195) 38 39Volquartsen Dale A MD 21

W

Ward Thomas E OD 39Watson Thomas D MD 20Williams Helen Y NP 19Wirthlin Laurie Sue MD 21

Y

Yoon David W MD 27

Z

Zane Linda J FNP 25 29

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover

Phone (800) 863-4155

httpwwwpartnershiphporg

Revision Date May 25 2018

  • Front Cover
  • Table of Contents
  • Introduction
    • How to use this list
    • Para usar esta lista
    • Glossary of Terms
    • Glosario de teacuterminos
    • Nondiscrimination Notice
    • Grievances
    • Aviso de no discriminacioacuten
    • Quejas
    • Language Assistance
    • Accessibility Standards
    • Estaacutendares de Accesibilidad
    • Timely Access to Care
    • Acceso oportuno a la atencioacuten meacutedica
    • How to read the Provider Directory
    • Como leer el Directorio de Proveedores
      • Shasta Primary Care Provider
        • Anderson
        • Burney
        • Cottonwood
        • Fall River Mills
        • Palo Cedro
        • Red Bluff
        • Redding
        • Round Mountain
        • Shasta Lake
        • Shingletown
          • Shasta Facilities Pharmacy Urgent Care amp VSP List
            • Hospitals Primary
            • Hospitals Referral
            • Mental Health Services - Outpatient
            • Pharmacy Network List
            • Skilled Nursing Long Term Care Facilities
            • Urgent Care Sites
            • Vision Service Plan (VSP) (1-800-877-7195)
              • Index
              • Back Cover