SANTA ROSA COMMUNITY HEALTH CENTERS (NPI# 1184909103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184909103 |
Entity Type | Organization |
Organization Name | SANTA ROSA COMMUNITY HEALTH CENTERS |
Other Organization Name | BROOKWOOD HEALTH CENTER |
Practice Address |
983 Sonoma Ave Santa Rosa CA 95404-4818 |
Mailing Address |
3569 Round Barn Cir Santa Rosa CA 95403-5781 |
Practice Telephone | 7075472220 |
Practice Fax Number | 7075270472 |
Mailing Telephone | 7075472220 |
Mailing Fax Number | 7075270472 |
Enumeration Date | 2011-10-21 |
Last Update Date | 2017-04-21 |
Authorized Official Name | MR. HAROLD BROCKMAN (CFO) |
Authorized Official Telephone | 7075838839 |
Is Organization Subpart | Y |
Parent Organization Name | SANTA ROSA COMMUNITY HEALTH CENTERS |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Brookwood Health Center | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962613349 | Santa Rosa Community Health Centers | Clinic/Center | 3569 Round Barn Circle, Santa Rosa, CA 95403-5781 | 2007-05-25 |
1871651273 | Santa Rosa Community Health Centers | Clinic/Center | 599 Bellevue Ave, Santa Rosa, CA 95407-7713 | 2006-12-05 |
1689742215 | Santa Rosa Community Health Centers | Clinic/Center | 684 Benecia Drive, Santa Rosa, CA 95409-3058 | 2006-12-01 |
1780195255 | Santa Rosa Community Health Centers | Clinic/Center | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2017-10-23 |
1518345511 | Santa Rosa Community Health Centers | Clinic/Center | 3333 Chanate Rd, Santa Rosa, CA 95404-1707 | 2015-05-11 |
1255600037 | Santa Rosa Community Health Centers | Community/Behavioral Health | 3569 Round Barn Cir, Santa Rosa, CA 95403-5781 | 2011-12-22 |
1558512624 | Santa Rosa Community Health Centers | Clinic/Center | 711 Stony Point Rd Ste 17, Santa Rosa, CA 95407-6848 | 2008-10-07 |
1114120623 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Court, Santa Rosa, CA 95407-6793 | 2007-06-11 |
1578766085 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Ct Ste B, Santa Rosa, CA 95407-6793 | 2007-06-11 |
1487857991 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Court, Santa Rosa, CA 95407-6793 | 2007-06-11 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | SANTA ROSA COMMUNITY HEALTH CENTERS | 3569 Round Barn Cir, Santa Rosa, CA 95403-5781 |
Street Address |
983 SONOMA AVE |
City | SANTA ROSA |
State | CA |
Zip Code | 95404-4818 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942225156 | Kameren Joy Owens | Nurse Practitioner | 983 Sonoma Ave, Santa Rosa, CA 95404-4818 | 2006-07-12 |
1558863779 | Reis Tucker-meade | Nurse Practitioner | 983 Sonoma Ave, Santa Rosa, CA 95404-4818 | 2018-03-03 |
1780121582 | Jotham Kahoro Gikuhi | Registered Nurse | 983 Sonoma Ave, Santa Rosa, CA 95404-4818 | 2017-01-31 |
1588850796 | Mary Catherine Papsco | Family Medicine | 983 Sonoma Ave, Santa Rosa, CA 95404 | 2007-09-20 |
1770612905 | Chris Stewart | Nurse Practitioner | 983 Sonoma Ave, Santa Rosa, CA 95404 | 2007-03-05 |
1144304114 | Joel M. Lewis | Family Medicine | 983 Sonoma Ave, Santa Rosa, CA 95404-4818 | 2006-10-25 |
1356421051 | Pamela S Domino | Registered Nurse | 983 Sonoma Ave, Santa Rosa, CA 95404 | 2006-10-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
1114492162 | Jesse Earl Rathbun Jr. | Ophthalmology | 1920 Grace Dr., Santa Rosa, CA 95404 | 2018-10-05 |
1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
1366940504 | New Leaf Counseling and Psychotherapy | Marriage & Family Therapist | 1030 2n Street, Suite B, Santa Rosa, CA 95404 | 2018-01-23 |
1659884864 | Jessica Vargas Lopez | Counselor | 3333 Chanate Road, Santa Rosa, CA 95404 | 2017-11-09 |
1982135992 | Gaea Keridwyn Coon | Marriage & Family Therapist | 884 Third Street, Suite D, Santa Rosa, CA 95404 | 2017-03-22 |
1376084699 | Empire Traditional Chinese Medicine | Acupuncturist | 1030 Second St, Santa Rosa, CA 95404 | 2017-03-20 |
1356888705 | Webster Surgery Center, Lp | Clinic/Center | 730 Bennett Valley Road, Santa Rosa, CA 95404 | 2017-01-24 |
1205295979 | Sandra Lee Krikorian | Social Worker | 101 E Street, Suite 312, Santa Rosa, CA 95404 | 2016-02-23 |
1396134615 | The Center for Body Oriented Psychotherapy & Wellness | Psychologist | 1626 Fourth Street, Santa Rosa, CA 95404 | 2015-01-12 |
Find all providers in zip 95404 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386960862 | Su Clinica Familiar | Clinic/Center | Hwy 107 and La Feria Avenue, Santa Rosa, TX 78593-0226 | 2010-04-09 |
1871651273 | Santa Rosa Community Health Centers | Clinic/Center | 599 Bellevue Ave, Santa Rosa, CA 95407-7713 | 2006-12-05 |
1245739697 | Santa Rosa Community Health Center | Clinic/Center | 3883 Airway Dr Ste 202, Santa Rosa, CA 95403-1671 | 2018-02-12 |
1780195255 | Santa Rosa Community Health Centers | Clinic/Center | 1300 N Dutton Ave, Santa Rosa, CA 95401-7112 | 2017-10-23 |
1518345511 | Santa Rosa Community Health Centers | Clinic/Center | 3333 Chanate Rd, Santa Rosa, CA 95404-1707 | 2015-05-11 |
1558512624 | Santa Rosa Community Health Centers | Clinic/Center | 711 Stony Point Rd Ste 17, Santa Rosa, CA 95407-6848 | 2008-10-07 |
1114120623 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Court, Santa Rosa, CA 95407-6793 | 2007-06-11 |
1578766085 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Ct Ste B, Santa Rosa, CA 95407-6793 | 2007-06-11 |
1487857991 | Santa Rosa Community Health Centers | Clinic/Center | 751 Lombardi Court, Santa Rosa, CA 95407-6793 | 2007-06-11 |
1568665073 | Santa Rosa Community Health Centers | Clinic/Center | 599 Bellevue Ave, Santa Rosa, CA 95407-7713 | 2007-06-11 |
Find all providers in SANTA ROSA |
City | SANTA ROSA |
Zip Code | 95404 |
Please comment or provide details below to improve the information on SANTA ROSA COMMUNITY HEALTH CENTERS.
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.