WEST COUNTY HEALTH CENTERS, INC. (NPI# 1356344758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356344758 |
| Entity Type | Organization |
| Organization Name | WEST COUNTY HEALTH CENTERS, INC. |
| Other Organization Name | RUSSIAN RIVER HEALTH CENTER |
| Practice Address |
16319 Third Street Guerneville CA 95446 |
| Mailing Address |
Po Box 1446 Guerneville CA 95446-1446 |
| Practice Telephone | 7078692849 |
| Practice Fax Number | 7078691477 |
| Mailing Telephone | 7078692849 |
| Mailing Fax Number | 7078691477 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2008-01-23 |
| Authorized Official Name | MISS TARI M WALLACE (BILLING DIRECTOR) |
| Authorized Official Telephone | 7078695977 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
XXXXXXX | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC03887F | 05 | |
| CA | FPACT | HAP03887F | 01 |
| CA | BLUE SHIELD PIN | ZZZ73222Z | 01 |
| Other Name | Type Code |
|---|---|
| Russian River Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598786352 | West County Health Centers, Inc. | Clinic/Center | 16312 Third Street, Guerneville, CA 95446 | 2006-07-21 |
| 1215488705 | West County Health Centers, Inc. | Clinic/Center | 16312 Third St, Guerneville, CA 95446 | 2016-10-19 |
| 1861809501 | West County Health Centers, Inc. | Clinic/Center | 652 Petaluma Ave, Sebastopol, CA 95472-4256 | 2014-07-15 |
| 1659630036 | West County Health Centers, Inc. | Clinic/Center | 6550 Front Street, Forestville, CA 95436-0000 | 2012-05-07 |
| 1538334065 | West County Health Centers, Inc. | Clinic/Center | 6800 Palm Ave, Suite C2, Sebastopol, CA 95472-4269 | 2008-04-25 |
| 1598768962 | West County Health Centers, Inc. | Clinic/Center | 3802 Main Street, Occidental, CA 95464 | 2005-05-31 |
| Street Address |
16319 THIRD STREET |
| City | GUERNEVILLE |
| State | CA |
| Zip Code | 95446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962728550 | Jared Nikolaus Garrison-jakel | Family Medicine | 16319 Third Street, Guerneville, CA 95446 | 2010-04-08 |
| 1548415508 | Jude Fox | Physician Assistant | 16319 Third Street, Guerneville, CA 95446 | 2008-11-18 |
| 1982854618 | Jerrold Paul Elliott IIi | Physician Assistant | 16319 Third Street, Guerneville, CA 95446 | 2008-09-30 |
| 1558528349 | Deette Deville | Family Medicine | 16319 Third Street, Guerneville, CA 95446 | 2008-05-20 |
| 1124226931 | Susan Maria Lavelle | Nurse Practitioner | 16319 Third Street, Guerneville, CA 95446 | 2007-07-03 |
| 1265449797 | Mary Wyman | Nurse Practitioner | 16319 Third Street, Guerneville, CA 95446 | 2006-08-01 |
| 1134135924 | Surani Hayre-kwan | Nurse Practitioner | 16319 Third Street, Guerneville, CA 95446 | 2006-07-31 |
| 1528072386 | West County Health Centers, Inc | Clinic/Center | 16319 Third Street, Guerneville, CA 95446-1449 | 2006-07-28 |
| 1689671968 | Steven Bromer | Family Medicine | 16319 Third Street, Guerneville, CA 95446 | 2005-07-01 |
| 1114923745 | Susan Skolek | Psychologist | 16319 Third Street, Guerneville, CA 95446 | 2005-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659840387 | Thomas N Tiffer | Taxi | 14701 Canyon 7 Rd, Guerneville, CA 95446 | 2018-11-26 |
| 1265969059 | Teresa Bowden | Counselor | 16255 1st Street, Guerneville, CA 95446 | 2017-05-11 |
| 1255882502 | Skye Ashley | Marriage & Family Therapist | 16390 Main Street, Guerneville, CA 95446 | 2016-10-21 |
| 1326461187 | Christopher Arthur Newell | Pharmacist | 16251 Main St., Lark Drugs, Guerneville, CA 95446 | 2014-01-30 |
| 1750658159 | Daryl Wolfe | Pharmacist | 16405 River Rd, Guerneville, CA 95446 | 2011-11-30 |
| 1881995041 | Declan Gerard Prendergast | Pharmacist | 16405 River Rd., Guerneville, CA 95446 | 2010-11-04 |
| 1154523272 | West County Community Services | Community/Behavioral Health | 14520 Armstrong Woods Rd, Guerneville, CA 95446 | 2007-06-01 |
| 1912128661 | Raymond Francis Skryja | Dentist | 14001 Old Cazadero Rd, Guerneville, CA 95446 | 2007-05-01 |
| 1598786352 | West County Health Centers, Inc. | Clinic/Center | 16312 Third Street, Guerneville, CA 95446 | 2006-07-21 |
| 1255365532 | Suzanne Kay Saville | Dentist | 16312 3rd Street, Guerneville, CA 95446 | 2006-07-10 |
| Find all providers in zip 95446 | ||||
| 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 |
|---|---|---|---|---|
| 1598786352 | West County Health Centers, Inc. | Clinic/Center | 16312 Third Street, Guerneville, CA 95446 | 2006-07-21 |
| 1215488705 | West County Health Centers, Inc. | Clinic/Center | 16312 Third St, Guerneville, CA 95446 | 2016-10-19 |
| 1528072386 | West County Health Centers, Inc | Clinic/Center | 16319 Third Street, Guerneville, CA 95446-1449 | 2006-07-28 |
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| Find all providers with the same taxonomy | ||||
| City | GUERNEVILLE |
| Zip Code | 95446 |
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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.