WELLSPACE HEALTH (NPI# 1215350848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215350848 |
| Entity Type | Organization |
| Organization Name | WELLSPACE HEALTH |
| Practice Address |
5959 Greenback Ln Ste 500 Citrus Heights CA 95621-4700 |
| Mailing Address |
1820 J St Sacramento CA 95811-3010 |
| Practice Telephone | 9167251177 |
| Practice Fax Number | 9168778225 |
| Mailing Telephone | 9165505481 |
| Mailing Fax Number | 9168228974 |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2017-08-18 |
| Authorized Official Name | MR. ALASDAIR JONATHAN PORTEUS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9167375555 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720546724 | Wellspace Health | Clinic/Center | 4241 Florin Rd Ste 30, Sacramento, CA 95823-2535 | 2019-03-08 |
| 1104210608 | Wellspace Health | Clinic/Center | 3535 65th St, Suite C, Sacramento, CA 95820-2057 | 2015-03-23 |
| 1265777692 | Wellspace Health | Clinic/Center | 631 H St, Sacramento, CA 95814 | 2012-12-12 |
| 1679819007 | Wellspace Health | Clinic/Center | 3415 Martin Luther King Jr. Blvd, Sacramento, CA 95817-3648 | 2012-12-12 |
| 1821357492 | Wellspace Health | Clinic/Center | 8231 E Stockton Blvd, Suite C, Sacramento, CA 95828-8202 | 2012-05-16 |
| 1225335581 | Wellspace Health | Clinic/Center | 5321 Stockton Blvd, Sacramento, CA 95820-5411 | 2011-02-23 |
| 1871617688 | Wellspace Health | Community/Behavioral Health | 1550 Juliesse Ave, Sacramento, CA 95817-3648 | 2007-03-19 |
| 1275687659 | Wellspace Health | Counselor | 8233 East Stockton Blvd., Suite D, Sacramento, CA 95817-3648 | 2007-01-22 |
| 1033295084 | Wellspace Health | Community/Behavioral Health | 4441 Auburn Blvd, Suite E, Sacramento, CA 95841-4139 | 2006-10-31 |
| 1558446179 | Wellspace Health | Community/Behavioral Health | 4343 Williamsbourgh Drive, Sacramento, CA 95823-2006 | 2006-10-25 |
| Street Address |
5959 GREENBACK LN STE 500 |
| City | CITRUS HEIGHTS |
| State | CA |
| Zip Code | 95621-4700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104917913 | Surekha N Reddy | Internal Medicine | 5959 Greenback Ln Ste 500, Citrus Heights, CA 95621-4700 | 2006-09-27 |
| 1295214443 | Jamie Martin | Physician Assistant | 5959 Greenback Ln Ste 500, Citrus Heights, CA 95621-4700 | 2018-08-08 |
| 1013415363 | Eryn Wicklow | Physician Assistant | 5959 Greenback Ln Ste 500, Citrus Heights, CA 95621-4700 | 2018-01-31 |
| 1356898688 | Darcy Wikoff | Nurse Practitioner | 5959 Greenback Ln Ste 500, Citrus Heights, CA 95621-4700 | 2016-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730612474 | Teaching Autistic Children, Inc | Behavioral Analyst | 6400 Tupelo Drive, Citrus Heights, CA 95621 | 2017-04-10 |
| 1164962023 | Elizabeth Devan | Behavior Technician | 6400 Tupelo Dr., Citrus Heights, CA 95621 | 2017-02-27 |
| 1407395940 | Jana Kenney | Counselor | 7327 #8 Auburn Oaks Court, Citrus Heights, CA 95621 | 2017-02-16 |
| 1306192026 | Steven C. Hammer, D.c. Professional Chiropractic Corp | Chiropractor | 6009 Auburn Blvd Ste 120, Citrus Heights, CA 95621 | 2012-07-31 |
| 1407131832 | Jason Court Richey | Pharmacist | 6144 Dewey Drive, Citrus Heights, CA 95621 | 2011-10-17 |
| 1184817488 | Robert Berry Mcvaugh | Marriage & Family Therapist | 6006 Broken Arrow Court, Citrus Heights, CA 95621 | 2007-08-21 |
| 1639379829 | Juliano Bianchi | Marriage & Family Therapist | 3650 A Auburn Blvd, Suite 200, Sacramento, CA 95621 | 2007-07-25 |
| 1043356785 | Louis J Orlando | Family Medicine | 5959 Greenback Lane Ste 210, Citrus Heights, CA 95621 | 2007-01-29 |
| 1578628483 | Wal-mart Stores, Inc. | Technician/Technologist | 7010 Auburn Blvd, Citrus Heights, CA 95621 | 2006-12-22 |
| 1417011461 | Rami Kaur Basrai | Dentist | 7001 Greenback Lane, Citrus Heights, CA 95621 | 2006-12-21 |
| Find all providers in zip 95621 | ||||
| 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 |
|---|---|---|---|---|
| 1730643990 | Wellspace Health | Clinic/Center | 7777 Sunrise Blvd Ste 2500, Citrus Heights, CA 95610-2372 | 2019-01-22 |
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| Find all providers with the same taxonomy | ||||
| City | CITRUS HEIGHTS |
| Zip Code | 95621 |
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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.