DIGNITY HEALTH MEDICAL FOUNDATION (NPI# 1053517797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053517797 |
| Entity Type | Organization |
| Organization Name | DIGNITY HEALTH MEDICAL FOUNDATION |
| Other Organization Name | DIGNITY HEALTH MEDICAL GROUP - DOMINICAN, A SERVICE OF DIGNITY HEALTH |
| Practice Address |
1820 41st Ave Suite D Capitola CA 95010-2516 |
| Mailing Address |
3000 Q St Sacramento CA 95816-7058 |
| Practice Telephone | 8314763000 |
| Practice Fax Number | 8314769009 |
| Mailing Telephone | 9167335701 |
| Mailing Fax Number | 9167333401 |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2014-12-17 |
| Authorized Official Name | GEORGE LENZI (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 9168512559 |
| Is Organization Subpart | Y |
| Parent Organization Name | DIGNITY HEALTH MEDICAL FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0091681 | 05 | |
| BSCA | ZZZ50287Z | 01 |
| Other Name | Type Code |
|---|---|
| Dignity Health Medical Group - Dominican, a service of Dignity Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710129275 | Dignity Health Medical Foundation | Clinic/Center | 105 Dean Way, Folsom, CA 95630-2801 | 2009-03-30 |
| 1447492905 | Dignity Health Medical Foundation | Clinic/Center | 6060 Watt Ave, North Highlands, CA 95660-4212 | 2009-03-30 |
| 1366684821 | Dignity Health Medical Foundation | Clinic/Center | 10487 White Rock Rd, Rancho Cordova, CA 95670-5530 | 2009-03-30 |
| 1558495937 | Dignity Health Medical Foundation | Clinic/Center | 7911 Laguna Blvd, Elk Grove, CA 95758-7920 | 2007-03-15 |
| 1780226852 | Dignity Health Medical Foundation | Clinic/Center | 17051 Sierra Lakes Pkwy Ste 101, Fontana, CA 92336-1274 | 2019-10-10 |
| 1568989200 | Dignity Health Medical Foundation | Clinic/Center | 3400 Data Dr, Rancho Cordova, CA 95670-7956 | 2017-08-24 |
| 1477074474 | Dignity Health Medical Foundation | Clinic/Center | 3400 Data Dr, Rancho Cordova, CA 95670-7956 | 2017-06-29 |
| 1679019798 | Dignity Health Medical Foundation | Clinic/Center | 6615 Valley Hi Dr, Sacramento, CA 95823-7076 | 2017-01-12 |
| 1508222647 | Dignity Health Medical Foundation | Clinic/Center | 18406 Roscoe Blvd, Northridge, CA 91325-4107 | 2016-01-05 |
| 1376926527 | Dignity Health Medical Foundation | Clinic/Center | 17051 Sierra Lakes Pkwy, Suite 101, Fontana, CA 92336-1274 | 2015-07-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DIGNITY HEALTH MEDICAL FOUNDATION | 3400 Data Dr, Rancho Cordova, CA 95670-7956 |
| Street Address |
1820 41ST AVE SUITE D |
| City | CAPITOLA |
| State | CA |
| Zip Code | 95010-2516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679560197 | Carla Collins Gorum | Pediatrics | 1820 41st Ave, Suite D, Capitola, CA 95010-2516 | 2005-09-29 |
| 1801334230 | Julia H Greenwood | Nurse Practitioner | 1820 41st Ave, Suite D, Capitola, CA 95010-2516 | 2017-02-06 |
| 1669811733 | Komal Afzal | Pediatrics | 1820 41st Ave, Suite D, Capitola, CA 95010-2516 | 2013-06-21 |
| 1134406135 | Shailinder Jeet Singh | Pediatrics | 1820 41st Ave, # 640, Capitola, CA 95010-2516 | 2011-11-04 |
| 1669702171 | Satu Alisa Larson | Nurse Practitioner | 1820 41st Ave, Suite D, Capitola, CA 95010-2516 | 2010-01-05 |
| 1710012919 | Lauden Pharmacy, Inc. | Pharmacy | 1820 41st Ave, Suite F, Capitola, CA 95010-2516 | 2007-02-21 |
| 1811090889 | Robert Moler | Pediatrics | 1820 41st Ave, Ste D, Capitola, CA 95010-2516 | 2006-09-06 |
| 1942283072 | Carmelita Feliciano Cristobal | Pediatrics | 1820 41st Ave, Suite D, Capitola, CA 95010-2516 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609436641 | Suzanne Lerner | Psychologist | 720a Capitola Ave, Capitola, CA 95010 | 2019-06-20 |
| 1801351317 | Michael Stephen Quinn | Chiropractor | 720 A- Capitola Ave, Capitola, CA 95010 | 2019-02-08 |
| 1053885194 | Health In Mind P.C. | Psychiatry & Neurology | 610 Capitola Ave, Capitola, CA 95010 | 2019-01-11 |
| 1427547355 | Jerry Wallace Fulford | Massage Therapist | 4170 Gross Rd. Extension, Suite 6, Capitola, CA 95010 | 2018-05-07 |
| 1457730293 | Cpap Experts LLC | Durable Medical Equipment & Medical Supplies | 820 Bay Ave #203a, Capitola, CA 95010 | 2015-05-26 |
| 1972904241 | Molly Chaudoir | Acupuncturist | 4170 Gross Rd. Ext., Suite 6, Santa Cruz, CA 95010 | 2014-09-05 |
| 1245598374 | Stan C Wolken | Dentist | 4770 Capitola Rd, Capitola, CA 95010 | 2012-04-26 |
| 1104103399 | Jacinda Ann Maurer | Registered Nurse | 4725 Grace Street, Apt. 1, Capitola, CA 95010 | 2011-11-16 |
| 1508043225 | Brian J. Schabel, Dds, Ms & Vivian H. Chan, Dds, Ms, Inc. | Dentist | 1830 41st Ave., Capitola, CA 95010 | 2008-01-24 |
| 1609066679 | Sandra Polakoff | Marriage & Family Therapist | 519 Capitola Avenue, Suite B, Capitola, CA 95010 | 2007-07-26 |
| Find all providers in zip 95010 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144426883 | Dignity Health Medical Foundation | Clinic/Center | 528 Capitola Ave, Capitola, CA 95010-2750 | 2007-06-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.