WESTERN SIERRA MEDICAL CLINIC, INC. (NPI# 1306324512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306324512 |
| Entity Type | Organization |
| Organization Name | WESTERN SIERRA MEDICAL CLINIC, INC. |
| Other Organization Name | WESTERN SIERRA MEDICAL CLINIC - KINGS BEACH |
| Practice Address |
8665 Salmon Avenue Kings Beach CA 96143 |
| Mailing Address |
844 Old Tunnel Rd Grass Valley CA 95945-8524 |
| Practice Telephone | 5302734984 |
| Practice Fax Number | 5302734573 |
| Mailing Telephone | 5302734984 |
| Mailing Fax Number | 5302734573 |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2018-07-31 |
| Authorized Official Name | FRANCINE NOVAK (CHIEF PLANNING AND DEVELOPMENT OFFI) |
| Authorized Official Telephone | 5302734984 |
| Is Organization Subpart | Y |
| Parent Organization Name | WESTERN SIERRA MEDICAL CLINIC, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
230000145 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1851513469 | 05 |
| Other Name | Type Code |
|---|---|
| Western Sierra Medical Clinic - Kings Beach | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144770793 | Western Sierra Medical Clinic, Inc. | Clinic/Center | 12183 Locksley Ln Ste 107, Auburn, CA 95602 | 2016-10-06 |
| 1336627546 | Western Sierra Medical Clinic, Inc. | Clinic/Center | 3111 Professional Dr, Auburn, CA 95603 | 2018-07-31 |
| 1356829576 | Western Sierra Medical Clinic, Inc. | Clinic/Center | 10544 Spenceville Rd, Penn Valley, CA 95946-9623 | 2018-07-31 |
| 1851513469 | Western Sierra Medical Clinic, Inc. | Clinic/Center | 209 Nevada Street, Downieville, CA 95936-0286 | 2007-05-03 |
| Street Address |
8665 SALMON AVENUE |
| City | KINGS BEACH |
| State | CA |
| Zip Code | 96143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407483761 | Pamela Mccarthy Murphy | Acupuncturist | 8762 North Lake Blvd, Kings Beach, CA 96143 | 2020-03-26 |
| 1053859033 | Barbara Ricotta | Acupuncturist | 8611 N. Lake Bl., Kings Beach, CA 96143 | 2017-02-09 |
| 1588115067 | Susan Smith | Counselor | 8491 N. Lake Blvd., Kings Beach, CA 96143 | 2016-10-19 |
| 1649670837 | Karen Kucharski | Dentist | 8079 N. Lake Blvd, 202, Kings Beach, CA 96143 | 2014-08-26 |
| 1063825917 | Sherry Thompson | Pharmacist | 8245 North Lake Blvd, Kings Beach, CA 96143 | 2014-06-09 |
| 1912277864 | Granite Wellness Centers | Community/Behavioral Health | 8491 North Lake Blvd., Kings Beach, CA 96143 | 2012-01-10 |
| 1588946859 | Richard Vanhalen Collins II | Pharmacist | 8245 North Lake Blv, Kings Beach, CA 96143 | 2011-09-13 |
| 1902107394 | William David Wickland | Dentist | 8233 Rainbow Avenue, Kings Beach, CA 96143 | 2010-11-16 |
| 1609177872 | Raymond Richard Wasson | Pharmacist | 7815 North Lake Blvd., Kings Beach, CA 96143 | 2010-11-04 |
| 1700057239 | Keri Lynn Gonsalves | Registered Nurse | 8645 North Lake Blvd., #c, Kings Beach, CA 96143 | 2008-03-12 |
| Find all providers in zip 96143 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
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| 1083251532 | Prime Wellness Community Health Center | Clinic/Center | 1824 1/2 W 38th Pl, Los Angeles, CA 90062-1012 | 2019-12-03 |
| Find all providers with the same taxonomy | ||||
| City | KINGS BEACH |
| Zip Code | 96143 |
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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.