ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC (NPI# 1194189654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194189654 |
| Entity Type | Organization |
| Organization Name | ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC |
| Other Organization Name | ST JOSEPH HEALTH RURAL HEALTH CLINIC |
| Practice Address |
3302 Renner Dr Fortuna CA 95540 |
| Mailing Address |
3300 Renner Dr Fortuna CA 95540-3120 |
| Practice Telephone | 7077253318 |
| Mailing Telephone | 7072694263 |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2018-08-09 |
| Authorized Official Name | MARIE ANTOINETTE SORCI (AREA DIRECTOR, REVENUE CYCLE) |
| Authorized Official Telephone | 7072694278 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST. JOSEPH HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1194189654 | 05 |
| Other Name | Type Code |
|---|---|
| St Joseph Health Rural Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558662098 | St. Joseph Health Northern California, LLC | General Acute Care Hospital | 248 Anzavista Ave, San Francisco, CA 94115 | 2010-11-16 |
| 1053529776 | St. Joseph Health Northern California, LLC | General Acute Care Hospital | 151 Sotoyome St, Santa Rosa, CA 95405 | 2007-05-18 |
| 1386717015 | St. Joseph Health Northern California, LLC | Clinic/Center | 3448 Villa Ln Ste 102, Napa, CA 94558 | 2006-11-17 |
| 1568422319 | St. Joseph Health Northern California, LLC | Durable Medical Equipment & Medical Supplies | 2612 Harrison Ave, Eureka, CA 95501 | 2006-03-24 |
| 1144415589 | St. Joseph Health Northern California, LLC | General Acute Care Hospital | 3300 Renner Dr, Fortuna, CA 95540 | 2007-09-10 |
| 1033325378 | St. Joseph Health Northern California, LLC | General Acute Care Hospital | 1000 Trancas St, Napa, CA 94558 | 2007-05-15 |
| 1285849026 | St. Joseph Health Northern California, LLC | General Acute Care Hospital | 3300 Renner Dr, Fortuna, CA 95540 | 2007-05-14 |
| 1891900635 | St. Joseph Health Northern California, LLC | General Acute Care Hospital | 2700 Dolbeer St, Eureka, CA 95501 | 2007-05-14 |
| 1346460466 | St. Joseph Health Northern California, LLC | Skilled Nursing Facility | 1165 Montgomery Dr, Santa Rosa, CA 95405 | 2007-04-30 |
| 1881814903 | St. Joseph Health Northern California, LLC | Rehabilitation Unit | 1165 Montgomery Dr, Santa Rosa, CA 95405 | 2007-04-30 |
| Street Address |
3302 RENNER DR |
| City | FORTUNA |
| State | CA |
| Zip Code | 95540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508897950 | Philip L Olkin | Family Medicine | 3302 Renner Dr, Fortuna, CA 95540-3120 | 2006-07-05 |
| 1699836981 | Philip L. Olkin, M.d. and C. Ray Jones, M.d. | Family Medicine | 3302 Renner Dr, Fortuna, CA 95540-3120 | 2006-12-12 |
| 1174558845 | Johnny Keith Coleman | Nurse Practitioner | 3302 Renner Dr, Fortuna, CA 95540-7103 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234787 | Remi Vista, Inc. | Community/Behavioral Health | 3000 Newburg, Fortuna, CA 95540 | 2020-01-21 |
| 1144867474 | Paula-marie Schneider | Registered Nurse | 3750 Rohnerville Rd., Fortuna, CA 95540 | 2019-12-05 |
| 1609265537 | Nancy Stinson Lollich | Physical Therapy Assistant | 2321 Newburg Road, Fortuna Rehabilitation and Wellness, Fortuna, CA 95540 | 2015-01-15 |
| 1730438151 | Heber House Inc. Dba Dermatology Center | Dermatology | 2404 Newburg Rd., Fortuna, CA 95540 | 2012-08-30 |
| 1104173418 | Michelle Leigh Hoopes | Physician Assistant | 3304 Renner Dr Suite B, Fortuna, CA 95540 | 2012-08-07 |
| 1205181526 | Constance Mitchell | Registered Nurse | Redwood Pediatrics, 3305 Renner Dr, Fortuna, CA 95540 | 2012-07-24 |
| 1730457177 | Joy Nadine Frasier | Counselor | 220 Wilson Ln., Fortuna, CA 95540 | 2011-12-13 |
| 1063791713 | Gardenside Eldercare, LLC | Residential Treatment Facility, Physical Disabilities | 529 9th Street, Fortuna, CA 95540 | 2011-08-12 |
| 1093025173 | Sheri A Jewett | Massage Therapist | 2655 Virginia Court, Fortuna, CA 95540 | 2010-10-07 |
| 1134371339 | Mariana Van Der Merwe | Pharmacist | 725 South Boulevard, Rite Aid Pharmacy, Fortuna, CA 95540 | 2008-10-21 |
| Find all providers in zip 95540 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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|---|---|---|---|---|
| 1821699620 | Reedley Community Hospital | Clinic/Center | 398 S Church Road, Earlimart, CA 93219 | 2020-11-06 |
| 1174130942 | Kaweah Delta Health Care District | Clinic/Center | 1000 N Mooney Blvd, Tulare, CA 93274-2417 | 2020-09-25 |
| 1922614197 | Sierra View Local Health Care District | Clinic/Center | 9520 Road 238, Terra Bella, CA 93270 | 2020-09-22 |
| 1124643598 | Valley Healthcare Centers | Clinic/Center | 369 N Church Rd, Earlimart, CA 93219 | 2020-06-11 |
| 1477177210 | Anand Narayan Md Inc | Clinic/Center | 317 W El Monte Way, Dinuba, CA 93618-1557 | 2020-06-06 |
| 1902435894 | Slt Medical Group Inc | Clinic/Center | 2024 Lake Tahoe Blvd, South Lake Tahoe, CA 96150-6498 | 2020-04-03 |
| 1881232676 | Madera Community Hospital | Clinic/Center | 121 Belmont Ave., Suite 101, Mendota, CA 93640 | 2019-12-12 |
| 1790331817 | Valley Healthcare Centers | Clinic/Center | 252 N Highway 65, Lindsay, CA 93247-2702 | 2019-08-14 |
| 1093274508 | Adventist Health Clearlake Hospital, Inc | Clinic/Center | 6300 E. Highway 20, Lucerne, CA 95458 | 2019-03-14 |
| 1679038434 | Ridgecrest Regional Hospital | Clinic/Center | 105 E Sydnor Ave, Ridgecrest, CA 93555-5546 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
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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.