NORTHERN CALIFORNIA MEDICAL ASSOC INC (NPI# 1245411529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245411529 |
| Entity Type | Organization |
| Organization Name | NORTHERN CALIFORNIA MEDICAL ASSOC INC |
| Practice Address |
104 Lynch Creek Way Ste 10 Petaluma CA 94954-2355 |
| Mailing Address |
3536 Mendocino Ave Ste 200 Santa Rosa CA 95403-3634 |
| Practice Telephone | 7077829123 |
| Practice Fax Number | 7077829622 |
| Mailing Telephone | 7075256485 |
| Mailing Fax Number | 7075736918 |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2008-10-16 |
| Authorized Official Name | MS. RUTH A SKIDMORE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7075736925 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | ZZZ51563Y | 01 |
| CA | 1245411529 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922640820 | Northern California Medical Assoc Inc | Internal Medicine | 830 2nd St Ste A, Santa Rosa, CA 95404-4620 | 2019-10-11 |
| 1235782921 | Northern California Medical Assoc Inc | Dermatology | 4727 Hoen Ave Ste A, Santa Rosa, CA 95405-7898 | 2019-07-22 |
| 1427509959 | Northern California Medical Assoc Inc | Dermatology | 555 S Dora St Ste B, Ukiah, CA 95482-5424 | 2016-10-19 |
| 1275945958 | Northern California Medical Assoc Inc | Dermatology | 1165 South Dora St, Ste G2, Ukiah, CA 95482-6353 | 2014-05-29 |
| 1225330459 | Northern California Medical Assoc Inc | Internal Medicine | 153 W Spruce St, Fort Bragg, CA 95437-3024 | 2010-11-19 |
| 1245492321 | Northern California Medical Assoc Inc | Podiatrist | 1701 4th St Ste 100, Santa Rosa, CA 95404 | 2008-06-30 |
| 1548262926 | Northern California Medical Assoc Inc | Internal Medicine | 558 3rd St W, Sonoma, CA 95476-6502 | 2005-08-15 |
| 1174525554 | Northern California Medical Assoc Inc | Internal Medicine | 84 Madrone St, Willits, CA 95490-4249 | 2005-08-15 |
| 1760481204 | Northern California Medical Assoc Inc | Internal Medicine | 4702 Hoen Ave, Santa Rosa, CA 95405-7824 | 2005-07-18 |
| 1073512661 | Northern California Medical Assoc Inc | Internal Medicine | 717 Center St, Healdsburg, CA 95448-3604 | 2005-07-18 |
| Street Address |
104 LYNCH CREEK WAY STE 10 |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-2355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639160112 | Jason Bacharach | Ophthalmology | 104 Lynch Creek Way, Suite 15, Petaluma, CA 94954-2355 | 2005-11-02 |
| 1972751915 | Saw Wynn Aye | Internal Medicine | 104 Lynch Creek Way, Ste 10, Petaluma, CA 94954-2355 | 2008-09-03 |
| 1073769055 | Jessica Flinders | Nurse Practitioner | 104 Lynch Creek Way, Suite 10, Petaluma, CA 94954-2355 | 2008-08-11 |
| 1538344742 | North Bay Eye Associates, A Medical Corporation | Durable Medical Equipment & Medical Supplies | 104 Lynch Creek Way, Suite 15, Petaluma, CA 94954-2355 | 2008-01-07 |
| 1346453297 | Loree Ann Skidmore | Nurse Practitioner | 104 Lynch Creek Way, Suite 10, Petaluma, CA 94954-2355 | 2007-05-08 |
| 1205936861 | James Francis Leoni | Family Medicine | 104 Lynch Creek Way, Ste 10, Petaluma, CA 94954-2355 | 2006-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669719043 | Roger Evan Minkow | Family Medicine | 735 H St, Petaluma, CA 94952-4936 | 2013-01-06 |
| 1285994244 | Tam Tiet | Family Medicine | 1383 N Mcdowell Blvd Ste 150, Petaluma, CA 94954 | 2012-05-24 |
| 1902976236 | El Rose Medical Group | Family Medicine | 24 West El Rose Ave, Petaluma, CA 94952 | 2006-11-08 |
| 1750472213 | Brian Bouch | Family Medicine | 616 Petaluma Blvd N, Suite C, Petaluma, CA 94952-2847 | 2006-09-27 |
| 1023043494 | Lana Ngoc Nguyen | Family Medicine | 3835 Cypress Dr, Suite 102, Petaluma, CA 94954-6965 | 2006-07-12 |
| 1083606776 | Kelly Pfeifer | Family Medicine | 1301 Southpoint Blvd, Petaluma, CA 94954-6858 | 2005-08-18 |
| 1013919190 | Daniel G White | Family Medicine | 3900 Lakeville Hwy, Petaluma, CA 94954-5698 | 2005-08-10 |
| 1366445785 | Michelle Davey | Family Medicine | 1179 N Mcdowell Blvd, Petaluma, CA 94954 | 2005-05-31 |
| 1588220636 | Northern California Medical Assoc | Family Medicine | 1116 B St, Petaluma, CA 94952-4054 | 2019-05-14 |
| 1427508241 | Ulysses Gomez | Family Medicine | 1179 N Mcdowell Blvd, Petaluma, CA 94954 | 2016-10-05 |
| Find all providers in PETALUMA | ||||
Please comment or provide details below to improve the information on NORTHERN CALIFORNIA MEDICAL ASSOC INC.
| 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.