PS
Medical Clinic
PINE STREET CLINIC
408 PINE ST, MOUNT SHASTA, CA 96067
Source updated 2026-10-16. Source-listed location, not a NursingHomes.io endorsement. Confirm operating status, care availability, and services directly.
Official provider information
- CCN
- 058674
- LTC
- NON-LTC
- NPI
- Not reported
- ZIP
- 96067
- id
- 5763
- CITY
- MOUNT SHASTA
- FLAG
- Not reported
- ZIP9
- 2126
- rank
- 0.0706241
- AO CD
- 7
- FACID
- 630014685
- DEEMED
- 1
- T18 19
- Not reported
- ADDRESS
- 408 PINE ST
- AO NAME
- AAAASF
- FACNAME
- PINE STREET CLINIC
- FAC FDR
- PRIMARY CARE CLINIC
- HCAI ID
- Not reported
- CAPACITY
- 0
- LATITUDE
- 41.31324
- LOCATION
- (-122.315301,41.31324)
- DATA DATE
- 2026-10-16T00:00:00
- ISFACMAIN
- N
- LONGITUDE
- -122.315301
- CCLHO CODE
- 47
- CCLHO NAME
- SISKIYOU
- START DATE
- 16MAY2014
- TRAUMA CTR
- Not reported
- ASPEN FACID
- 630014685
- COUNTY CODE
- 570
- COUNTY NAME
- SISKIYOU
- TERMINAT SW
- Not reported
- AO TRMNTN DT
- 05/16/2026
- DMG EFCTV DT
- 2023-05-16T00:00:00
- PARENT FACID
- 230000012
- TYPE OF CARE
- Not reported
- APPROVAL DATE
- 2017-08-07T00:00:00
- BUSINESS NAME
- DIGNITY HEALTH
- DISTRICT NAME
- CHICO
- FAC TYPE CODE
- RHC/OP
- LICENSE NUMBER
- 230000015
- TRAUMA PED CTR
- Not reported
- DISTRICT NUMBER
- 23
- FIPS COUNTY CODE
- 6093
- LICENSED CERTIFIED
- LICENSED AND CERTIFIED
- PARTICIPATION DATE
- 2014-05-16T00:00:00
- CONTACT PHONE NUMBER
- (530) 926-7196
- FAC STATUS TYPE CODE
- OPEN
- INITIAL LICENSE DATE
- 1976-04-13T00:00:00
- BIRTHING FACILITY FLAG
- Not reported
- CAN BE DEEMED FAC TYPE
- Y
- LICENSE EFFECTIVE DATE
- 2026-06-01T00:00:00
- ENTITY TYPE DESCRIPTION
- NONPROFIT CORP
- LICENSE EXPIRATION DATE
- 2026-11-27T00:00:00
- CRITICAl ACCESS HOSPITAL
- Not reported
- CAN BE CERTIFIED FAC TYPE
- Y
- LICENSE STATUS DESCRIPTION
- ACTIVE
- FAC FAC RELATIONSHIP TYPE CODE
- OTHER CERTIFIABLE PART
COMMUNITY EXPERIENCE
Reviews of PINE STREET CLINIC
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